Impaired insight in patients with newly diagnosed nonaffective psychotic disorders with and without deficit features.
Impaired insight in patients with newly diagnosed nonaffective psychotic disorders with and without deficit features.
复制标题
新诊断的有或没有缺陷特征的非情感性精神病患者的洞察力受损。
DOI：
10.1016/j.schres.2010.08.024
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发表时间：
2011
影响因子：
4.5
通讯作者：
Compton,MichaelT
中科院分区：
文献类型：
--
作者：
Trotman,HananD;Kirkpatrick,Brian;Compton,MichaelT
与非缺陷型患者相比，具有原发性、持续性阴性症状或缺陷综合征的精神分裂症患者的心理社会功能较差，但临床痛苦较轻。缺陷型精神分裂症患者对损伤的认识不足可能导致了这种表面上的矛盾。我们假设，在缺陷患者的疾病过程中早期会出现自知力差，并且那些具有缺陷特征的患者比那些没有缺陷特征的患者在自知力方面有更大的损害。将101例首发非情感性精神障碍患者分为缺陷组（n=31）和非缺陷组（n=70）。当使用自我报告问卷进行评定时，缺陷患者的洞察力明显差于非缺陷患者，临床研究人员评定的洞察力几乎明显较差。此外，这种影响仍然是自我评价的洞察力，并达到统计学意义的研究人员评定的洞察力后，控制积极的，消极的，一般的精神病理学症状。这些结果表明，治疗缺陷患者可能是特别复杂的洞察力差。
Patients with schizophrenia who have primary, enduring negative symptoms, or the deficit syndrome, have poorer psychosocial functioning but lesser clinical distress compared with nondeficit patients. Poor awareness of impairment in patients with deficit schizophrenia may contribute to this seeming contradiction. We hypothesized that poor insight would be present early in the course of illness in deficit patients, and that those with deficit features would have greater impairment in insight than those without deficit features. One-hundred one first-episode patients with nonaffective psychotic disorders were categorized into deficit (n=31) and nondeficit (n=70) groups. The deficit patients had significantly poorer insight than nondeficit patients when rated using a self-report questionnaire, and nearly significantly poorer insight rated by clinical researchers. Further, this effect remained for self-rated insight and reached statistical significance for researcher-rated insight after controlling for positive, negative, and general psychopathology symptoms. These results suggest that the treatment of deficit patients may be particularly complicated by poor insight.