精神分裂症患者病耻感调查及相关因素分析

Survey of stigma and factors related with stigma in schizophrenic patients

目的了解精神分裂症患者的病耻感状况以及其相关因素。方法 2011年1月至3月间抽取95名精神分裂症患者,采用自编一般情况量表及内在耻感问卷及病耻感经历问卷进行调查。同时以阳性症状量表(SAPS)及阴性症状量表(SANS)、社会支持量表(SSRS)、生活质量量表(WHOQOL-BREF)对其评定。结果 (1)内在耻感量表:疏离因子2.29(sd=0.49),刻板因子2.07(sd=0.44),歧视因子2.15(sd=0.45),退缩因子2.19(sd=0.46),总量表分2.17(sd=0.38);内在耻感量表中各因子分超过中点值2.5分的病例比例为:疏离因子44.2%,刻板因子14.7%,歧视因子25.3%,退缩因子32.6%,调整后的内在耻感量表总分20.0%,超过2.5者提示有较强内在病耻感;(2)病耻感经历量表:病耻感体验因子2.50(sd=0.59),介于"很少发生"与"有时发生"之间;歧视经历因子1.71(sd=0.39),介于"从不发生"到"很少发生"之间,总量表分2.08(sd=0.39)介于"很少发生"与"有时发生"之间;病耻感经历量表中各因子分超过中值3分的病例比例为:受试者病耻感经历各因子及总分超过中点值3分的百分比为:病耻感体验因子24.2%(n=23),歧视经历因子1.1%(n=1),病耻感经历总分1.1%(n=1),超过3分者提示病耻经历较多;(3)以内在耻感总分作为因变量回归分析,提示与内在耻感显著相关的因素为学历、病期、职业、社会支持中的对支持的利用度分量表及生活满意度量表中的心理领域等。结论 (1)精神分裂症患者中存在较高水平的病耻感;(2)患者文化、社会支持和生活质量是其内在耻感的主要相关因素。

Objective To investigate the stigma experienced by schizophrenic patients and it’s relevant factors.Methods 95 schizophrenic patients were recruited in the current study.ISMI,MCESQ,WHOQOL –BREF,SSRS,SAPS and SANS were used to assess the participants.Results（1） ISMI： alienation 2.29（sd=0.49）,stereotype endorsement 2.07（sd=0.44）,perceived discrimination 2.15（sd=0.45）,social withdrawal 2.19（sd=0.46）,average total score 2.17（sd=0.38）.The percentage of participants that rated above 2.5（mid-point） on the subscales and total scores of ISMI,which means high level of self-stigma,were： alienation 44.2%,stereotype endorsement 14.7%,perceived discrimination 25.3%,social withdraw 32.6%,and total score 20.0%.（2）MCESQ： stigma experiences 2.50（sd=0.59）,between＂seldom＂and ＂sometimes＂;discrimination experiences 1.71（sd=0.39）,between ＂never＂ and ＂seldom＂,total average score 2.08（sd=0.39）,between ＂seldom＂ and ＂sometimes＂.The percentage of participants that rated above 3（mid-point） on the subscales and total scores of MCESQ,which means more discriminatory experiences,were： stigma experiences 24.2%,discrimination experiences 1.1%,total average score 1.1%.（3） Total average ISMI score was selected as dependent variable to be performed multivariate linear regression analysis,indicating that self-stigma are correlated significantly with education level,duration of mental illness,employment status,utility of social support and satisfaction of psychological domain of quality of life.Conclusion（1） Patients with schizophrenia have high level of stigma.（2） Education,social support and quality of life could be the relevant factors of patients’ stigma.