首发与复发精神分裂症患者亚型分布及精神症状的比较

Comparison Study on the Clinical Subtypes Distribution and Symptoms between Patients with First-episode and Re-episode Schizophrenia

目的:分析比较首发与复发精神分裂症患者的亚型分布及精神症状,为早期干预积累资料。方法:对80例首发和80例复发精神分裂症患者进行系统精神检查,同时评定简明精神病量表(BPRS)、阴性症状量表(SANS)、阳性症状量表(SAPS),然后对亚型分布和精神症状进行对比分析。结果:①两组患者均以偏执型和未定型为主,但首发组没有衰退期(型)患者,而复发组紧张型的比例较低(P<0.05);②两组间精神症状的检出率基本相似(P>0.05),但复发组的阴性症状检出率显著高于首发组(P<0.05);③BPRS总分及因子分、SAPS总分两组间无显著性差异,而SANS总分则复发组显著高于首发组(P<0.01)。结论:首发与复发精神分裂症各有其特点,首发与复发的划分,在早期治疗指导、预后评估和复发预防方面仍有其现实意义。

Objective： To compare the clinical subtypes distribution and symptoms between patients with first-episode and re-episode schizophrenia,so as to accumulate data for early intervention.Method： Totally 80 cases with first-episode and 80 cases with re-episode schizophrenia were performed systematic psychiatry examination.At the same time,they were rated the Brief Psychiatric Rating Scale（BPRS）,the Scale for Assessment of Negative Symptoms（SANS） and the Scale for Assessment of Positive Symptoms（SAPS）.Then,the clinical subtypes distribution and symptoms between the patients with first-episode and re-episode schizophrenia were analyzed.Result： ①Paranoid type and undifferentiated type were mainly found both in two groups,but,the first-episode group had no decline type and the re-episode group had lower catatonic type rate（P0.05）.②The appearance rate of psychotic symptoms was similar between the two groups（P0.05）.But,the incidence of negative symptom showed significantly higher in re-episode group than in first-episode group（P0.05）.③The total scores of BPRS and SAPS,and BPRS＇s factors scores showed no significant difference between the two groups,but,the total score of SANS showed significantly higher in re-episode group than in first-episode group（P0.01）.Conclusion： Patients with first-episode or re-episode schizophrenia have their own characters.Differentiation between first-episode and re-episode groups still has practical significance of early interventing direction,prognosis evaluation and re-episode prevention.