401例精神分裂症病人阴、阳性症状的分布及演变

Changes in the distribution of the positive and negative symptoms of 401 hospitalized schizophrenic patients.

本文用中文版的阴、阳性症状量表,前瞻性地用盲法收集了四所精神病医院符合DSM—ⅢR标准的401例住院精神分裂症病人入院、出院时的资料,结果显示,阴性症状在疾病的急性期和阳性症状相近,但在缓解期重于阳性症状,阴性症状在精神分裂症的诊断、治疗、评价疗效时同阳性症状一样重要。在亚型分布及演变方面,在急性期52.9％病人为混合型,从急性期到恢复期亚型发生了变化,但很少有阴性为主型和阳性为主型之间的相互转变,这说明阴、阳性之间有着根本的差异,支持以阴性为主和以阳性为主的精神分裂症可能是两个独立的疾病单元或者是两个不同综合征的假说。

This study adopted the Chinese versions of SANS and SAPS to assess prospectively and blindly the negative and positive symptoms of 401 patients that were in accord with DSM-Ⅲ-Rschizophrenic criteria at the time of admission and discharge from four Chinese psychiatric hospitals.The results showed that the overall severity of negative symptoms was comparable with that of positive symptoms on adission and found that it is greater than that of the positive symptoms at discharge.Thus negative symptoms might be as important as positive symptoms in the diagnosis of schizophrenia,in the choice of treatment modalities,and in the evaluation of therapeutic efficacy.Most patients who were classified as 'Positive Type' schizophrenics or 'Negative Type' schizophrenics (according to Andreasen's criteria) at the time of admission changed to 'Mixed Type' schizophrenics at discharge; there was,however,rarely crossover between Positive Type and Negative Type.This supports the hypothesis that Positive Type schizophrenia and Negative Type schizophrenia are either separated diagnostic entities or two different schizophrenic syndromes.