首发未治疗精神分裂症患者生活质量与精神症状的关联

为了探讨首发未用药的精神分裂症患者与接受治疗的精神分裂症患者之间的生活质量有无显著性差异,生活质量与精神分裂症症状之间是否存在关联,选取美国《精神疾病诊断与统计手册(第4版)》(DSM-IV)诊断明确的门诊和住院精神分裂症患者共99例,同时纳入年龄、文化程度无差异的健康对照57例;采用世界卫生组织(WHO)生存质量测定量表简表(WHOQOL-BREF)和阳性与阴性症状量表(PANSS)对患者进行评估.结果显示:生活质量首发未治疗组和治疗组精神分裂症患者均显著低于对照组(F=13.660,P=0.000),首发未用药组生活质量总评分及心理评分显著低于治疗组(P=0.019,P=0.007);首发未用药组精神分裂症环境、生活质量总分与PANSS阴性症状分之间存在明确的负性关联(R=-0.479,P=0.000;R=-0.288,P=0.045);治疗组精神分裂症患者环境评分、生活质量总分与PANSS阴性症状分之间存在明确的正相关(R=0.319,P=0.024;R=0.284,P=0.045).由此,可以得出精神分裂症患者的生活质量显著下降;首发未用药的精神分裂症患者的生活质量较已经接受药物治疗的患者明显下降;患者的精神症状的严重程度,尤其是阴性症状的严重程度与其生活的环境质量息息相关.

Relationship between quality of life and psychiatric symptoms in first-episode untreated Schizophrenia.

The purpose of this study was to investigate whether there was a significant difference in quality of life between first-episode schizophrenic patients and patients taking medical treatment, furthermore to investigate the correlation between quality of life and symptoms of schizophrenia. Ninety-nine out-patients and in-patients with schizophrenia were selected according to the 4th edition of the American Mental Disease Diagnosis and Statistics Manual (DSM-IV), and 57 healthy controls with no difference in age and degree were included. The patients were assessed by WHO Quality of Life Scale (WHOQOL-BREF) and Positive and Negative Symptoms Scale (PANSS).The quality of life in the first-episode group and the treatment group were significantly lower than those in the control group (F=13.660, P=0.000). The total quality of life score and psychological score in the first-episode group were significantly lower than those in the treatment group (P=0.019, P=0.007).There was a clear negative correlation between the total score of environment, quality of life and PANSS negative symptoms (R=-0.479, P=0.000; R=-0.288, P= 045) in the first-episode non-medication group. There was a clear positive correlation between the environmental score and the total score of quality of life in the treatment group and the negative score of PANSS (R = 0.319, P = 0.024; R = 0.284, P = 0.045). It is concluded that the quality of life of schizophrenic patients decreased significantly. The quality of life of first-episode schizophrenic patients was significantly lower than that of the treatment group. The severity of mental symptoms, especially the severity of negative symptoms was closely related to the quality of living environment.