精神分裂症和抑郁症患者自我反思与洞察力水平及特征研究

The ability and characteristic of self-reflection and insight in schizophrenia and depression patients

目的探讨精神分裂症患者与抑郁症患者的自我反思与洞察力水平及其特点。方法运用自我反思与洞察力量表（The Self-Reflection and Insight Scale，SRIS）对方便选取的精神分裂症组（140例），抑郁症组（92例）与健康对照组（131例）的自我反思与洞察力水平进行测试，同时进行多伦多述情障碍量表（Toronto Alexithymia Scale-20，TAS-20）评估。结果（1）精神分裂症组和抑郁症组的SRIS总分[（73.51±12.78）分、（79.94±11.11）分]、自我反思（RE）[（42.08±10.95）分、（47.48±9.19）分]、洞察力（IN）[（31.43±4.92）分、（32.46±5.70）分]低于健康对照组[（86.84±12.70）分、（51.73±9.95）分、（35.11±5.48）分]，均差异有统计学意义（均P〈0.05） 。（2）精神分裂症组SRIS总分[（73.51±12.78）分]、RE[（42.08±10.95）分]低于抑郁症组SRIS总分[（79.94±11.11）分]、RE[（47.48±9.19）分]，均差异有统计学意义（P〈0.05）；但精神分裂症组与抑郁症组的洞察力因子得分差异无统计学意义（P〉0.05）。（3）精神障碍患者组TAS-20量表得分与RE得分（r＝－0.227，P〈0.05）、IN得分（r＝－0.538，P〈0.01）呈显著相关性。结论精神障碍患者存在自我反思及洞察力方面不同程度的损伤，抑郁症患者比精神分裂症患者在自我反思方面的受损程度低。

ObjectiveTo investigate the ability of the self-reflection and insight in schizophrenia and depression patients and their characteristics.MethodsSelf-reflection and insight scale （SRIS） and the toronto alexithymia scale-20（TAS-20）were used to test the self-reflection and insight of 140 schizophrenia patients, 92 depression patients and 131 healthy controls.Results（1）The SRIS score（（73.51±12.78）, （79.94±11.11））, self-reflection（RE） score （（42.08±10.95）, （47.48±9.19）） and insight（IN） score（（31.43±4.92）, （32.46±5.70）） in schizophrenia and depression patients were significantly lower than those in healthy controls （SRIS score（86.84±12.70）, RE score（51.73±9.95）, IN score（35.11±5.48））, and the differences were statistically significant（P〈0.05）. （2）The SRIS score（73.51±12.78） and RE score（42.08±10.95） in schizophrenia group were significantly lower than those in depression group （（79.94±11.11）, （47.48±9.19））, and the differences were statistically significant （P〈0.05）; but the scores of insight factors had no difference between schizophrenia group and depression group （P〉0.05）. （3） The correlation between TAS-20 score and RE score （r=-0.227, P〈0.05） and IN score （r=-0.538, P〈0.01） was statistically significant in patients with mental disorder.ConclusionPatients with mental disorder have different levels of self-reflection and insight impairment. Patients with depression suffer from a lower degree of self-reflection than schizophrenia patients.