首发精神分裂症和抑郁症患者症状严重程度与儿童期创伤、心理弹性及社会支持的相关性分析

Correlation analysis of childhood trauma,psychological resilience and social support in patients with first-episode schizophrenia and depression

目的 探讨首发精神分裂症和抑郁症患者症状严重程度与儿童期创伤、心理弹性及社会支持的关系。方法 采用方便抽样法,选取2019年12月至2022年1月在河北医科大学第一医院精神卫生中心住院和门诊就诊的91例首发精神分裂症患者、121例抑郁症患者为精神分裂症组和抑郁症组。同期选取在我院进行体检的110名健康人为对照组。采用阳性与阴性症状量表(PANSS)、汉密尔顿抑郁量表(HAMD)、儿童期创伤问卷(CTQ)、心理弹性量表(CD-RlSC)及社会支持量表(SSRS)进行测评。采用Spearson相关分析精神分裂症患者、抑郁症患者症状严重程度与童年期创伤、心理弹性、社会支持的相关性。结果 精神分裂症组患者的PANSS评分为(90.70±12.36)分,CTQ总分为39(32,46)分,CD-RISC总分为31(24,37)分,SSRS评分为30(24,34)分。抑郁症组患者的HAMD评分为(19.60±3.92)分,CTQ总分为37(33,45)分,CD-RISC总分为36(28,42)分,SSRS评分为31(27,35)分。对照组的CTQ总分为35(31,40)分,CD-RISC总分为44(40,48)分,SSRS评分为33(27,40)分。3组受试者的CTQ总分和情感忽视、躯体虐待维度评分比较,差异有统计学意义(Z=13.183、8.486、10.947;P<0.05)。3组受试者的SSRS评分、CD-RISC总分及坚韧性、力量性、乐观性维度评分比较,差异有统计学意义(Z=9.586、96.975、63.131、40.765、77.894;P<0.01)。精神分裂症患者的PANSS评分、抑郁症患者的HAMD评分与情感忽视维度评分、躯体虐待维度评分、CTQ总分呈正相关(r=0.278、0.283、0.210、0.248、0.272、0.209;P<0.05)。精神分裂症患者的PANSS评分与CD-RISC总分和各维度评分、SSRS评分呈负相关(r=-0.617、-0.424、-0.471、-0.598、-0.316;P<0.01)。抑郁症患者的HAMD评分与CD-RISC总分、坚韧性维度评分、乐观性维度评分、SSRS评分呈负相关(r=-0.427、-0.235、-0.799、-0.236;P<0.01)。结论 首发精神分裂症和抑郁症患者儿童期经历过情感忽视、躯体虐待,且缺乏心理弹性及社会支持,疾病的严重程度与心理弹性及社会支持功能呈负相关。

Objective To explore the relationship between childhood trauma,psychological resilience and social support,and the severity of symptoms in patients with first-episode schizophrenia and depression.Methods A total of 91 first-episode schizophrenic patients and 121 first-episode depressive patients in the inpatient department and outpatient of the Mental Health Center of the First Hospital of Hebei Medical University from December 2019 to January 2022 were selected as the research subjects.At the same time,a total of 110 health controls were recruited as control group from the patients for physical examination in our hospital.All subjects were assessed by Positive and Negative Symptom Scale(PANSS),Hamilton Depression Scale(HAMD),Childhood Trauma Questionnaire(CTQ),Connor-Davidson Resilience Scale(CD-RISC) and Social Support Rate Scale(SSRS).Spearson correlation was used to analyze the correlation between the severity of symptoms of schizophrenia and depression patients and childhood trauma,psychological resilience and social support.Results The scores of PANSS,CTQ,CD-RISC and SSRS in schizophrenia group were(90.70±12.36),39(32,46),31(24,37) and 30(24,34),respectively.The scores of HAMD,CTQ,CD-RISC and SSRS in depression group were(19.60±3.92),37(33,45),36(28,42) and 31(27,35),respectively.The scores of CTQ,CD-RISC and SSRS in the control group were 35(31,40),44(40,48) and 33(27,40),respectively.The differences of total score of CTQ and the scores of emotional neglect and physical abuse among the three groups were statistically significant(Z=13.183,8.486,10.947;P < 0.05).The differences of SSRS score,CD-RISC total score,tenacity,strength and optimism scores among the three groups were statistically significant(Z=9.586,96.975,63.131,40.765,77.894;P<0.01).The PANSS score of schizophrenia group and the HAMD score of depression group were positively correlated with the emotional neglect dimension score,the physical abuse dimension score and the total CTQ score(r=0.278,0.283,0.210,0.248,0.272,0.209;P < 0.01).The PANSS score of schizophrenia group was negatively correlated with the total score and all dimension scores of CD-RISC,and the SSRS score(r=-0.617,-0.424,-0.471,-0.598,-0.316;P < 0.01).The HAMD score of depression patients was negatively correlated with the CD-RISC total score,tenacity dimension score,optimism dimension score and SSRS score(r=-0.427,-0.235,-0.799,-0.236;P < 0.05).Conclusions First-episode schizophrenic and depressive patients have experienced emotional neglect and physical abuse in childhood,and lack of resilience and social support.The severity of the disease is negatively related to resilience and social support.