以被害妄想为主的精神分裂症患者自尊、应对方式及其与精神症状的关系

Characteristics and Relationship of Self-esteem,Coping Styles and Psychotic Symptoms in Schizophrenia Patients with Persecutory Delusions

目的探讨精神分裂症被害妄想患者的自尊及应对方式的特点,及其与精神症状间的关系。方法采用阳性和阴性症状量表(PANSS)、自尊量表(RSES)、应对方式问卷及Zung抑郁自评量表(SDS),分别对82例精神分裂症被害妄想患者及50名正常对照进行评估。结果①被害妄想患者的自尊与问题解决及求助应对方式显著低于对照组(t=8.951,4.167;P<0.001;t=3.083,P<0.01),而逃避、自责及幻想应对显著高于对照组(t=3.175,5.426;P<0.001;t=6.797,P<0.01);患者抑郁情绪显著高于对照组(t=4.569,P<0.001);②患者的自尊与问题解决及求助呈正相关(r=0.326,0.341;P<0.01),而与自责及逃避呈负相关(r=-0.274,-0.321;P<0.01);③患者的被害妄想症状与自尊呈负相关(r=-0.282,P<0.05)。结论精神分裂症被害妄想患者持有低自尊及消极应对特点,低自尊容易产生被害妄想。

Objective To explore the characteristics of self-esteem,coping styles andtheir relationship with psychotic symptoms in schizophrenia patient with persecutory delusions.Methods A total of 82 schizophrenia patients with persecutory delusions and 50 controls were assessed with Positive and Negative Symptom Scale（PANSS）,Rosenberg Self-esteem Scale（RSES）,Coping Styles Questionnaire and Zung Self-rating Depression Scale（SDS）.Results ① Compared with controls,the levels of the patient＇ self-esteem,problem solving and seeking help were lower,while the levels of withdrawal,self-blame and fancy were much higher（t=8.951,4.167;P0.001;t=3.083,P0.01）.The score of SDS of patients was significantly higher than the controls（t=4.569,P0.01）.②The level of patients＇ self-esteem showed a significantly positive correlation with problem solving（r=0.326,0.341,P0.01）and seeking help but negative correlation with self-blame and withdrawal（r=-0.274,-0.321;P0.01）.③ The severity of persecutory delusions were negatively associated with the level of self-esteem（r=-0.282,P0.05）.Conclusion Schizophrenia patients with persecutory delusions have low self-esteem and negative coping styles.Low self-esteem can easily cause severity of persecutory symptoms.