摘要
目的:探讨精神分裂症关系妄想患者的临床特征、神经认知与心理防御特点。方法:2017年1月至2018年12月某院精神科门诊或病房收治的100例首发精神分裂症患者。根据阳性症状量表(SAPS)得分情况将100例受试者分为关系妄想组(46例)和非关系妄想组(54例)。选择同期来本院进行体检的健康人50例,设为健康对照组。对所有受试者进行牵连观念访谈表(IRIS)评估。对首发精神分裂症患者进行阳性症状量表(SAPS)、阴性症状量表(SANS)评估。使用Babble测验评价受试者的听觉提取情况。使用轮廓整合测验评价受试者的视觉提取情况。应用防御方式问卷(DSQ)评价受试者的心理防御状况。应用自测健康评定量表(SRHMSV 1.0)评价受试者生理健康、心理健康和社会健康。结果:Babble检测结果显示,关系妄想组的错误词数明显多于非关系妄想组和健康对照组(F=6.509,P<0.01),错词长度均明显长于非关系妄想组和健康对照组,差异均有统计学意义(F=33.838,P<0.01)。轮廓整合测验结果显示,关系妄想组随机测验正确总分、标准测验的正确总分均明显低于非关系妄想组和健康对照组,错误总分均明显高于非关系妄想组和健康对照组,差异有统计学意义(F=9.447,7.449,10.367,12.445;P<0.05)。防御方式问卷(DSQ)检测结果显示,关系妄想组投射、潜意显现、抱怨、压抑、理想化、伴无能之全能、隔离、同一化、否认、交往倾向、因子3、掩饰因子的得分均与非关系妄想组、健康对照组存在明显统计学差异(F=6.321~18.478,P<0.05)。关系妄想组的生理健康、心理健康和社会健康评分及SRHMSV 1.0量表总分均明显低于非关系妄想组和健康对照组,差异均有统计学意义(F=14.276,12.122,14.306,20.033;P<0.05)。结论:对听觉、视觉水平的无关信息的过度提取,以及较多的应用不成熟的心理防御机制,可能是精神分裂症关系妄想患者的病理基础。
Objective:To explore the clinical features,neurocognitive and psychological defense characteristics of schizophrenic patients with delusion of reference.Methods:From January 2017 to December 2018,100 patients with first episode schizophrenia admitted to the outpatient department or ward of the psychiatric department of our hospital.According to the positive symptom scale(SAPS)scores,100 subjects were divided into the delusion of reference group(46 cases)and the non-delusion of reference group(54 cases).50 healthy people who came to our hospital for physical examination during the same period were selected as the healthy control group.All subjects were evaluated using the involvement concept interview form(IRIS).Positive symptom scale(SAPS)and negative symptom scale(SANS)were evaluated in patients with first episode schizophrenia.Babble test was used to evaluate the auditory extraction of the subjects.Contour integration test was used to evaluate the visual extraction of subjects.Defense style questionnaire(DSQ)was used to evaluate the psychological defense status of the subjects.The subjects’physical,mental and social health were evaluated by SRHMSV 1.0.Results:Babble test results showed that the number of incorrect words in the delusion of reference group was significantly higher than that in the non-delusion of reference group and the healthy control group(F=6.509,P<0.01),and the length of incorrect words was significantly longer than that in the non-delusion of reference group and the healthy control group,with statistically significant differences(F=33.838,P<0.01).The results of contour integration test showed that the correct total score of the random test and the standard test in the delusion of reference group were significantly lower than those in the non-delusion of reference group and the healthy control group,and the wrong total score was significantly higher than that in the non-delusion of reference group and the healthy control group,and the difference was statistically significant(F=9.447,7.449,10.367,12.445;P<0.05).The results of the defense style questionnaire(DSQ)showed that the scores of projection,latent intention,complaint,depression,idealization,omnipotence,isolation,homogenization,denial,communication tendency,factor 3 and cover-up factor in the delusion of reference group were significantly different from those in the non-delusion of reference group and the healthy control group(F=6.321~18.478,P<0.05).The scores of physiological health,mental health and social health and the total score of SRHMSV 1.0 scale in the relational delusional group were significantly lower than those in the non-relational delusional group and the healthy control group,with statistically significant differences(F=14.276,12.122,14.306,20.033;P<0.05).Conclusion:Excessive extraction of irrelevant information on auditory and visual levels,as well as more application of immature psychological defense mechanism,may be the pathological basis of schizophrenic patients with paranoid relationship.
作者
平丽慧
祁继鹏
魏冬
吴光现
潘振山
PING Lihui;QI Jipeng;WEI Dong(Department of Psychiatry,Luoyang Fifth Peoples Hospital,Luoyang 471000,China)
出处
《中国健康心理学杂志》
2020年第7期971-976,共6页
China Journal of Health Psychology
关键词
精神分裂症
关系妄想
临床特征
神经认知
心理防御
Schizophrenia
Delusion of reference
Clinical features
Neurocognitive
Mental defense
