首发恢复期精神分裂症患者人格特征、应对方式及社会支持与心理健康的相关研究

The related correlation of mental characteristics,coping style,social support and mental health between schizophrenia primary affection and convalescent schizophrenia

目的 探讨首发恢复期精神分裂症患者人格特征、应对方式、社会支持、心理健康状况及其之间的相关性,为进一步制定首发恢复期精神分裂症患者的综合康复计划提供理论依据.方法 采用症状自评量表、人格特质测量问卷、简易应对方式问卷、社会支持量表对150例经新型非典型抗精神病药治疗、首发恢复期的门诊精神分裂症患者（患者组）和170例健康人（对照组）的人格特征、应对方式、社会支持、心理健康状况及其之间的相关性进行比较.结果 患者组与全国常模scl-90：躯体化[（1.83±0.14）分vs.（1.27±0.48）分]、人际敏感[（1.96±0.21）分vs.（1.65±0.51）分]、抑郁[（1.89±0.24）分vs.（1.50±0.59）分]、焦虑[（1.69±0.15）分vs.（1.39±0.43）分]、恐怖[（1.56±0.13）分vs.（1.23±0.41）分]、精神病因子[（1.56±0.14）分vs.（1.23±0.41）分]得分比较,差异均有统计学意义,（P＜0.01）.患者组与正常组个性特征：神经质[（3.13±0.15）分vs.（2.61±0.36）分]、外倾性[（2.96±0.31）分vs.（3.19±0.23）分]、宜人性[（3.20±0.25）分vs.（3.48±0.35）分]、责任心[（3.19±0.65）分vs.（3.42±0.16）分]得分比较,差异均有统计学意义.（P＜0.01）.患者组与正常组社会支持：主观支持[（23.51±3.62）分vs.（26.29±3.91）分]、客观支持[（7.35±2.07）分vs.（8.91±2.89）分]、对支持的利用[（7.61±1.23）分vs.（8.97±1.35）分]、支持总分[（37.63±6.52）分vs.（43.51±6.32）分]得分比较,差异均有统计学意义.（P＜0.01）.患者组与正常组应对方式：积极应对[（27.03±6.05）分vs.（33.75±4.53）分]、消极应对[（32.63±5.31）分vs.（43.51±6.32）分]得分比较,差异均有统计学意义,（P＜0.01）.患者组抑郁因子与强迫因子、客观支持与敌对因子、消极应对与敌对、神经质因子正相关.恐怖因子与强迫、抑郁因子,责任心因子与精神病因子、消极应对,神经质因子与躯体化因子负相关.结论 制定首发、恢复期精神分裂症患者的综合康复计划时,必须基于整合医学视角,积极关注其个性特征、心理健康状况、应对方式、社会支持等方面.

Objective By exploring difference of mental characteristics,coping style,social support and health between schizophrenia primary affection and convalescent schizzy,it＆#39;s expected that the related rationale will be developed for further formulating treatment for schizophrenia primary affection and convalescent schizophrenia.Methods By taking advantage of symptom checklist,questionnaire of NEO-FFI,Simplified Coping Style Questionnaire,social support scale,we compared 150 schizophrenia primary affection who were under the clinic of new antipsychotics and in convalescent period （schizzy group）with 169 normal persons （normal group）on the mental characteristics,coping style,social support and mental health of individual and correlation.Results The following factors of scl-90 showed statistical significance between patient group and normal group：somatization （1.83±0.14） vs.（1.27-±0.48）,interpersonal sensitivity（1.96±0.21） vs.（1.65±0.51）,depression（1.89±0.24） vs.（1.50±0.59）,anxiety（1.69±0.15） vs.（1.39±0.43）,photic anxiety （1.56±0.13） vs.（1.23±0.41）,psychoticism factors （1.56± 0.14） vs.（1.23±0.41） （all P〈0.01）.The personality traits differences between patient group and normal group were as follows：neuroticism （3.13± 0.15） vs.（2.61 ± 0.36）,extraversion （2.96± 0.31） vs.（3.19± 0.23）,agreeableness （3.20± 0.25） vs.（3.48±0.35） and conscientiousness （3.19±0.65） vs.（3.42± 0.16）,and all these factors showed statistical significance with P〈0.01.The differences of subjective support factors between patients group and normal groups were as follows：subjective support （23.51 ±3.62） vs.（26.29±3.91）,objective support （7.35±2.07） vs.（8.91 ± ±2.89）,support use （7.61± 1.23） vs.（8.97± 1.35） and total score of supports （37.63± 6.52） vs.（43.51 ± 6.32） and the scores of patients group were poorer than those of normal group（P〈0.01）.These two groups also showed statistical significance in coping styles：positive coping style（27.03±6.05） vs.（33.75±4.53） and negative coping style （32.63±5.31） vs.（43.51±6.32）,patient group got lower scores than normal group（P〈0.01）.Depression factor and obsessive compulsive symptom factor,objective support and hostility factor,passive coping and hostility,neuroticism factor in patients group are positive correlation,and photic anxiety factor and obsessive compulsive symptom,depression factor,conscientiousness factor and psychoticism factor,passive coping,neuroticism factor and somatization factor were negative correlation.Conclusion A effective recovery plan of treatment of schizophrenia primary affection and convalescent schizzy must integrate medical perspective,active interest in his personality characteristics,mental health,coping style,social support.