精神分裂症患者快感缺失与童年创伤经历的相关性

The relationship between anhedonia and childhood trauma in schizophrenic patients

目的：探讨精神分裂症患者快感缺失与童年创伤经历的关系。方法采用中文版修订社会快感缺失量表（RSAS-C）、中文版修订躯体快感缺失量表（RPAS-C）和童年创伤问卷（ CTQ）对198例精神分裂症患者和271例正常健康者进行评估,分析快感缺失与童年创伤间的关系。结果患者组RSAS-C评分（13．32±6．12）、RPAS-C评分（19．04±8．53）、CTQ总分（47．63±13．49）及其各因子分均显著高于正常组（分别为10．40±5．05,16．80±7．89,38．82±10．05）,差异有统计学意义（ P＜0．05）；患者组RSAS-C评分、RPAS-C评分与阳性与阴性症状量表（ PANSS）总分及阴性症状分均呈正相关（rs =0．266~0．439,P＜0．01）；患者组RSAS-C评分（rs =0．419,P＜0．01）和RPAS-C评分（rs =0．322,P＜0．01）与CTQ总分呈正相关,控制PANSS总分后,快感缺失评分与童年创伤评分间的相关性仍存在。结论精神分裂症患者快感缺失程度较高,与童年创伤经历之间存在关联,提示早年的创伤经历可能会影响个体对躯体及社会交往快乐的体验能力。

Objective To explore the relationship between anhedonia and childhood trauma in patients with schizo-phrenia. Methods 198 schizophrenic patients and 271 healthy subjects were asked to completed the Revised So-cial Anhedonia Scale-Chinese Version （ RSAS-C） , the Revised Physical Anhedonia Scale-Chinese Version （ RPAS-C） and the Childhood Trauma Questionnaire （CTQ）. Results In the patients group, the RSAS-C score（13. 32 ± 6. 12）, RPAS-C score（19. 04 ± 8. 53）, CTQ total score（47. 63 ± 13. 49） and its five factors scores were signifi-cantly higher than those in the control group （ 10. 40 ± 5. 05 , 16. 80 ± 7. 89 , 38. 82 ± 10. 05 , respectively ） （ P〈0. 05）. Correlation analysis showed that in the patients group, the RSAS-C score and RPAS-C score were signifi-cantly positively correlated with the Positive and Negative Syndrome Scale （ PANSS ） total score and its negative score（rs=0. 266~0. 439,P〈0. 01）. The RSAS-C score（rs=0. 419,P〈0. 01） and RPAS-C score（rs=0. 322,P〈0. 01） were also significantly positively correlated with CTQ total score in the patients group. After controlling PANSS total score, there were also correlations between RSAS-C, RPAS-C scores and CTQ scores. Conclusion Anhedonia is related to childhood trauma in schizophrenia patients, suggesting that the trauma during childhood may affect the ability to experience physical and interpersonal pleasure.