首诊中青年精神分裂症患者内化病耻感现状及影响因素

Present situation and influencing factors of internal medicine stigma of young and middle-aged patients with schizophrenia in first diagnosis

目的了解首诊中青年精神分裂症患者内化病耻感现状及影响因素,以期为制定提升患者心理健康水平的相关策略提供参考。方法采用一般资料问卷、精神分裂症内化病耻感、社会适应功能量表、自尊量表、共情能力量表,于2017年5月—2018年4月对四川省4家三级精神专科医院首次确诊的276例中青年精神分裂症患者进行调查。结果首诊中青年精神分裂症患者病耻感评分为75.47±6.32,处于中等水平。自尊评分为21.57±4.125,社会功能评分为42.23±9.161,共情能力评分为38.12±5.206,与内化病耻感呈负相关(r=-0.666、-0.643、-0.456,均P<0.01)。多元回归分析显示,自尊、文化程度、家庭氛围、社会功能、共情能力、住院天数可解释首诊中青年精神分裂症患者内化病耻感总变异的77.7%,是其主要影响因素。结论首诊中青年精神分裂症患者内化病耻感严峻,临床医务人员应根据其主要影响因素,采取针对性干预措施,提升其心理健康水平,降低由病耻感带来的不良结局。

Objective To understand the status and influencing factors of internal medicine stigma of young and middle-aged patients with schizophrenia in first diagnosis,provide reference for the formulation of related strategies to improve the mental health level of patients.Methods Using the General Information Questionnaire,Schizophrenia Internal Medicine Disorder,Social Adaptation Function Scale,Self-Esteem Scale,and Emotional Capacity Scale,276 young and middle-aged patients with schizophrenia diagnosed for the first time in four tertiary psychiatric hospitals in Sichuan Province were investigated from May2017 to April 2018.Results Among young and middle-aged patients with schizophrenia in first diagnosis,the stigma score was75.47±6.32,which was at a medium level,the score of self-esteem was 21.57±4.125,the score of social function was 42.23±9.161,and the score of empathy ability was 38.12±5.206,which was negatively correlated with the internalized disease stigma of(r=-0.666,-0.643,-0.456,all P<0.01).Multivariate regression analysis showed that self-esteem,educational level,family atmosphere,social function,empathy and hospitalization days could explain the 77.7%of total variation of internalization stigma in young and middle-aged patients with schizophrenia in first diagnosis,which were the main influencing factors.Conclusion The young and middle-aged patients with schizophrenia in first diagnosis have severe internal medical stigma.Clinical staff should adopt targeted intervention strategies based on their main influencing factors to improve their mental health and reduce the adverse outcomes caused by stigma.