精神分裂症患者生活质量与自知力及精神症状的关系

The Relationship between Quality of Life and Insight,Psychiatric Symptoms in Patients with Schizophrenia

目的:探讨精神分裂症患者自知力及精神症状对生活质量的影响。方法:选取符合美国精神疾病诊断与统计手册第4版(DSM-IV)中精神分裂症诊断标准的医院门诊和住院患者共180例。采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)、自知力评定量表(SAI)、阳性与阴性症状量表(PANSS)对患者进行评估。结果:生活质量的生理因子与依从性、疾病意识、精神症状标识及自知力总分显著负相关(r=-0.232,-0.243,-0.171,-0.274;P<0.05);心理因子与疾病意识和自知力总分显著负相关(r=-0.219,-0.203;P<0.01);生活质量总分与疾病意识和自知力总分负相关(r=-0.169,-0.175;P<0.05),生活质量受自知力总分和阴性症状的影响(β=-0.312,P=0.000;β=-0.157,P=0.037),疾病意识对生活质量心理因子有预测作用(β=-0.291,P=0.003);生活质量总分受自知力总分的影响(β=-0.594,P=0.019)。结论:1自知力较好的患者生活质量较低;2心理因子受疾病意识的影响;3阴性症状对生活质量有影响。

Objective：To investigate the effect of insight into illness and psychiatric symptoms on quality of life in patients with schizophrenia.Methods：One hundred and eighty patients with stable schizophrenia were enrolled in our study.These patients met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition（DSM-IV） criteria for schizophrenia.The World Health Organization Quality ofLife（WHOQOL-BREF）,Schedule for Assessing Insight（SAI） and Positive and Negative Syndrome Scale（PANSS） were used to assessment.Results：Physiological factors in the quality of life had significantly negative correlation with three factors scores and total score of insight（r =-0.232,-0.243,-0.171,-0.274; P〈0.05）.The psychological factor and disease awareness and total score of insight were significantly negative correlation（r =-0.219,-0.203; P〈0.01）.The total score of quality of life had significantly negative correlation with disease awareness and total score of insight（r =-0.169,-0.175; P〈0.05）.The total score of insight and negative syndrome could be used to predict physiological factors（β=-0.312,P = 0.000; β =-0.157,P = 0.037）; Awareness of disease had forecasts on the psychological factor（β =-0.291,P = 0.003）.The total score of quality of life was affected by total score of insight（β =-0.594,P = 0.019）.Conclusion：① Patients with good insight into illness have lower quality of life.②Psychological factor is affected by awareness of disease.③ Negative syndrome has an impact on quality of life.