Wellness within illness: happiness in schizophrenia.
Wellness within illness: happiness in schizophrenia.
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DOI：
10.1016/j.schres.2014.07.027
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发表时间：
2014-10
影响因子：
4.5
通讯作者：
Jeste DV
中科院分区：
文献类型：
--
作者：
Palmer BW;Martin AS;Depp CA;Glorioso DK;Jeste DV
精神分裂症是一种典型的慢性疾病，是严重精神疾病中最严重的一种，对生活质量有不利影响。然而，有人建议，一些精神分裂症患者可以在生活中体验到整体的幸福感。我们调查了72名平均病程为24.4年的非缓解型慢性精神分裂症门诊患者和64名健康对照组（HC）的幸福感。尽管继续使用抗精神病药物治疗，精神分裂症患者仍表现出轻度至中度的精神病理学水平。精神分裂症患者的平均幸福水平低于HC，但精神分裂症组内存在实质性异质性。精神分裂症患者的幸福水平与较高的心理健康相关生活质量和几个积极的心理社会因素（较低的感知压力，较高的弹性，乐观和个人掌握水平）显着相关。然而，幸福水平与社会人口学特征、疾病持续时间、阳性或阴性症状的严重程度、身体功能、医疗合并症或认知功能无关。除了缺乏与韧性的关联外，在HC中看到的幸福与其他变量的相关性模式与精神分裂症患者相似。虽然在严重的精神疾病背景下，幸福可能更难实现，但它似乎是精神分裂症的一个可行的治疗目标。针对积极应对因素的心理治疗，如弹性，乐观和个人掌握值得进一步研究。
Schizophrenia is typically a chronic disorder and among the most severe forms of serious mental illnesses in terms of adverse impact on quality of life. Yet, there have been suggestions that some people with schizophrenia can experience an overall sense of happiness in their lives. We investigated happiness among 72 outpatients with non-remitted chronic schizophrenia with a mean duration of illness of 24.4 years, and 64 healthy comparison subjects (HCs). Despite continued treatment with antipsychotic medications, the individuals with schizophrenia manifested a mild to moderate level of psychopathology. People with schizophrenia reported lower mean levels of happiness than HCs, but there was substantial heterogeneity within the schizophrenia group. Level of happiness in persons with schizophrenia was significantly correlated with higher mental health-related quality of life, and several positive psychosocial factors (lower perceived stress, and higher levels of resilience, optimism, and personal mastery). However, level of happiness was not related to sociodemographic characteristics, duration of illness, severity of positive or negative symptoms, physical function, medical comorbidity, or cognitive functioning. Except for an absence of an association with resilience, the pattern of correlations of happiness with other variables seen among HCs was similar to that in individuals with schizophrenia. Although happiness may be harder to achieve in the context of a serious mental illness, it nonetheless appears to be a viable treatment goal in schizophrenia. Psychotherapies targeting positive coping factors such as resilience, optimism, and personal mastery warrant further investigation.