Cognitive approach to depression and suicidal thinking in psychosis 2. Testing the validity of a social ranking model
Cognitive approach to depression and suicidal thinking in psychosis 2. Testing the validity of a social ranking model
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DOI：
10.1192/bjp.177.6.522
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发表时间：
2000-12-01
影响因子：
10.5
通讯作者：
Trower, P
中科院分区：
文献类型：
--
作者：
Iqbal, Z;Birchwood, M;Trower, P
背景 在论文 I 中，我们报道了急性期抑郁症随着精神病的缓解而缓解，36% 的患者出现了精神病后抑郁症 (PPD)。目的 我们将认知框架应用于 PPD，并绘制自我评估和精神病及其与后来出现 PPD 的联系。方法 ICD-IO 精神分裂症患者 (n=105) 在急性发作后随访 12 个月以上，采取抑郁、工作自我概念、认知等措施。结果 在患上产后抑郁症之前，这些患者比那些复发或未抑郁的患者因疾病而感到更大的失落、羞辱和困扰，并且更有可能看到自己未来处于“较低地位”的角色。一旦变得沮丧。参与者的洞察力增强，自尊心降低，对精神病的评价恶化。结论 精神病中的抑郁源于个人对精神病的评价及其对他/她感知的社会身份、地位和“群体适应性”的影响。患有产后抑郁症的患者感到被迫接受从属角色，没有逃脱的机会。讨论了治疗的意义。
Background In paper I we reported that depression in the acute stage remitted in line with the psychosis and that 36% of patients developed post-psychotic depression (PPD).Aims We apply our cognitive framework to PPD and chart the appraisal of self and psychosis and their link with the later emergence of PPD.Method Patients with ICD-IO schizophrenia (n=105) were followed up over 12 months following the acute episode, taking measures of depression, working self-concept, cognitive vulnerability, insight and appraisals of psychosis.Results Before developing PPD,these patients felt greater loss, humiliation and entrapment by their illness than those who relapsed or did not become depressed, and were more likely to see their future selves in 'lower status' roles. Upon becoming depressed. participants developed greater insight, lower self-esteem and a worsening of their appraisals of psychosis.Conclusions Depression in psychosis arises from the individual's appraisal of psychosis and its implications for his/her perceived social identity, position and 'group fit'. Patients developing PPD feel forced to accept a subordinate role without opportunity for escape. Implications for treatment are discussed.