精神分裂症的强迫症状及其临床特征的分析

An analysis between obsessive compulsive symptoms and its clinical characteristics in the patients with schizophrenia

目的 为探讨精神分裂症的强迫症状及其临床特征。方法 采用MMOCI、Y -BOCS、PANSS评定了符合CCMD -2 -R中精神分裂症诊断标准的住院精神分裂症病人 812例。并将其中合并有强迫症状者 75例随机分为两组进行 8周的对照治疗 ,同时进行Pearson相关分析。结果 精神分裂症的强迫症状发生率为 9.2 4% ,其中只有强迫思维者占 64 .0 % ,强迫思维与强迫行为均有者占 3 6.0 %。前者的PANSS、MMOCI、Y -BOCS评分、强迫症状所占的时间、对社会功能的影响 ,以及所带来的痛苦分都较低 ,而抵抗分较高 ,两组比较有显著差异。利培酮合并安慰剂组和利培酮合并氯丙咪嗪组的疗效都很明显 ,尤以后者较好。治疗前后强迫症状的评分都与PANSS、阳性症状及一般病理分呈显著的正相关 ,而与阴性症状分无关。结论 作者认为 ,强迫症状是精神分裂症的常见症状 ,可能是精神分裂症固有症状的成份之一。

Objective To explore the obsessive compulsive symptoms and its clinical characteristics in the patients with schizophrenia.Methods 812 schizophrenic inpatients who met with CCMD-2-R criteria,were evaluated with MMOCI,Y-BOCS and PANSS.75 schizophrenic patients with obsessive compulsive symptoms were selected and randomly divided into two groups for treating 8 weeks.Pearson correlations were done.Results the prevalence of obsessive compulsive symptoms in schizophrenia was 9.24%.The patients only with obsessions were 64.0%,and with obsessions and compulsions were 36.0%.The patients only with obsessions had lower baseline PANSS,MMOCI,Y-BOCS scores,and had lower baseline scores of time,function and anxiety,and higher scores of conflict to obsessive compulsive symptoms.The effects of two groups of risperidone combination with placebo and risperidone combination with clomipramine were both obvious,but the effcts of the later group were significantly better.The scores of obsessive compulsive symptoms were positive correlations with PANSS,positive and general scores,but not with negtive scores before and after treatment.Conclusions Obsessive compulsive symptoms were very common symtoms in schizophrenia,and could be one of indigenous symptoms to schizophrenia.