Awareness of illness in schizophrenia and schizoaffective and mood disorders.
Awareness of illness in schizophrenia and schizoaffective and mood disorders.
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DOI：
10.1001/archpsyc.1994.03950100074007
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发表时间：
1994-10
影响因子：
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通讯作者：
X. Amador;M. Flaum;N. Andreasen;D. Strauss;S. Yale;S. Clark;J. Gorman
中科院分区：
文献类型：
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作者：
X. Amador;M. Flaum;N. Andreasen;D. Strauss;S. Yale;S. Clark;J. Gorman
关于精神分裂症患者的洞察力或自我意识的文献表明，这种认知维度可能具有分类学价值。缺乏洞察力在精神分裂症的现象学和神经心理学水平上具有描述性有效性，并且在预测病程方面具有预后有效性。缺乏经验数据的诊断特异性的洞察力，精神分裂症和以前使用洞察力的措施可疑的可靠性和有效性限制了这一解释。方法：在本研究中，我们使用一种具有可靠度和效度的测量方法来评估对精神障碍多个方面的洞察力。研究人员对来自美国不同地区和一个国际站点的412名精神病和情绪障碍患者进行了研究。主要目的是确定精神分裂症诊断患者自我意识缺陷的患病率，检查与精神分裂症相关的自我意识缺陷的相对严重程度，与伴有和不伴有精神分裂症的分裂情感性和情绪障碍患者相比较，并评估精神分裂症患者自我意识的临床相关性。结果：洞察力差是精神分裂症的普遍特征。精神分裂症患者的各种自我意识缺陷比伴有或不伴有精神病的分裂情感性或重度抑郁症患者更为严重和普遍，并与较差的社会心理功能相关。结论：严重的自我意识缺陷是精神分裂症的一个普遍特征，可能源于与精神分裂症相关的神经心理功能障碍，并且在精神分裂症中比在其他精神障碍中更常见。
BACKGROUND The literature on insight, or self-awareness, in schizophrenia suggests that this cognitive dimension may be of nosological value. Poor insight has descriptive validity at the phenomenological and neuropsychological levels of schizophrenia and has prognostic validity in terms of the prediction of the course of illness. The lack of empirical data on the diagnostic specificity of poor insight to schizophrenia and the previous use of insight measures with questionable reliability and validity have limited this interpretation. METHODS In the present study, we assessed insight into multiple aspects of mental disorder using a measure with demonstrated reliability and validity. A sample of 412 patients with psychotic and mood disorders coming from geographically diverse regions of the United States and one international site was studied. The main aims were to determine the prevalence of self-awareness deficits in patients in whom schizophrenia was diagnosed, to examine the relative severity of self-awareness deficits associated with schizophrenia compared with that of schizoaffective and mood disorders with and without psychosis, and to evaluate the clinical correlates of self-awareness in patients with schizophrenia. RESULTS The results indicated that poor insight is a prevalent feature of schizophrenia. A variety of self-awareness deficits are more severe and pervasive in patients with schizophrenia than in patients with schizoaffective or major depressive disorders with or without psychosis and are associated with poorer psychosocial functioning. CONCLUSIONS The results suggest that severe self-awareness deficits are a prevalent feature of schizophrenia, perhaps stemming from the neuropsychological dysfunction associated with the disorder, and are more common in schizophrenia than in other psychotic disorders.