精神分裂症抑郁与述情障碍、自测健康的关系

Relationship of schizophrenic depressive symptoms with alexithymia and self-rating health

目的探讨精神分裂症患者抑郁情绪的特征及其影响因素。方法采用自编一般情况问卷、自评抑郁量表(SDS)、多伦多述情量表(TAS)、自测健康状况评定量表(SRHMS)对320例精神分裂症患者与98名抑郁症患者进行评定,并进行相关与回归分析。结果 (1)精神分裂症组SDS总分≥40分的有142例,占46.71%。精神分裂症组在SDS总分及精神-情感性症状、精神运动性障碍方面评分均显著低于抑郁症组(P<0.01)。(2)医疗负担、自测健康状况、TAS总分等因素中共有15个因素与精神分裂症患者SDS总分显著相关(r=0.133～0.479,P<0.05或P<0.01)。(3)自测健康评定量表总分、TAS总分、住院次数、医疗负担、家族史依次进入精神分裂症SDS总分的回归方程。结论精神分裂症患者抑郁情绪较常见,程度比抑郁症患者轻,自测健康状况、述情障碍、医疗负担等是其抑郁情绪严重程度的重要影响因素。

Objective To explore the characteristics of depressive mood and related factors in patients with schizophrenia. Methods A total of 320 patients with schizophrenia and 98 major depression were assessed with a self-designed questionnaire, Self-Rating Depression Scale and Depression Status Inventory （SDS）, Toronto Alexithymia Scale （TAS） and Self-rating Health Measurement Scale Version 1.0 （SRHMS）. Correlation and regression analysis were carried out. Results 304 schizophrenic patients completed questionaires, in which 140 patients had SDS total score over 40. Compared with major depressive patients, patients with schizophrenia showed significantly lower total score of SDS, scores of psych-affective symptoms and psychomotor disturbance （P〈0.01）. There were 15 factors such as the medical burden and condition of self-related health showed significant correlation with total score of SDS in schizophrenics （r = 0. 133 - 0. 479, P〈0.05 or P〈 0.01）. SRHMS total score, TAS total score, hospitalized times, medical burden and family history entered the regression equation for total score of SDS in patients with schizophrenia by turns. Conclusion Depressive symptoms are very common in patients with schizophrenia, and the severity is milder than that of major depression. The self-rating health, alexithymia and medical burden are responsible for the severity of depressive mood in pa- tients with schizophrenia.