Resilience and its inter-relationship with symptomatology, illness course, psychosocial functioning, and mediational roles in schizophrenia: A systematic review

IF 2.8 3区医学 Q2 PSYCHIATRY Asia‐Pacific Psychiatry Pub Date : 2021-08-25 DOI:10.1111/appy.12486

Jerry Jay Yeo MBBS Candidate, Qian Hui Chew B.Soc.Sci (Hons), Kang Sim MBBS, MMed (Psychiatry), Grad Dip Psychotherapy (Distinction), MS-HPEd, FAMS

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引用次数: 11

Abstract

Background

Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors.

Methods

A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020.

Results

Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions.

Discussion

Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.

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精神分裂症的恢复力及其与症状学、病程、社会心理功能和中介作用的相互关系:系统综述

精神分裂症是一种严重的精神疾病，给患者带来了沉重的疾病负担。鉴于有必要更好地理解越来越多的关于心理弹性(面对逆境的适应)及其临床相关性的文献，以便为精神分裂症的临床管理提供信息和优化，我们试图总结现有的文献，这些文献研究了心理弹性与人口特征、现象学、病程、社会心理功能之间的相互关系，以及其在相关因素中的中介作用。方法对截至2020年12月已发表的实证研究进行了系统回顾，研究了精神分裂症谱系条件下的弹性和临床相关因素。结果高水平的恢复力与较低的特定症状严重程度相关，包括阳性、阴性、抑郁症状、自杀意念、认知缺陷和更好的洞察力。此外，较高的复原力与病程的不同方面显著相关(如精神病未治疗的持续时间较短，疾病持续时间较长，症状缓解和恢复改善)，内部因素(如更低的耻辱，更好的自尊)和心理社会功能(更好的整体，现实生活，社会和人际功能，更好的生活质量)。在精神分裂症谱系条件下，恢复力也在导致抑郁、功能和生活质量的途径中起中介作用。在各种复原力模型(补偿、挑战、保护因素模型)的背景下，提出了增强复原力和平衡风险与保护因素的建议，以改善疾病管理。未来的研究应寻求更好地阐明相关的生物标志物，与照顾者心理弹性的相互关系，并评估针对精神分裂症的心理弹性干预措施的有效性。

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来源期刊

Asia‐Pacific Psychiatry PSYCHIATRY-

CiteScore

7.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Asia-Pacific Psychiatry is an international psychiatric journal focused on the Asia and Pacific Rim region, and is the official journal of the Pacific Rim College of Psychiatrics. Asia-Pacific Psychiatry enables psychiatric and other mental health professionals in the region to share their research, education programs and clinical experience with a larger international readership. The journal offers a venue for high quality research for and from the region in the face of minimal international publication availability for authors concerned with the region. This includes findings highlighting the diversity in psychiatric behaviour, treatment and outcome related to social, ethnic, cultural and economic differences of the region. The journal publishes peer-reviewed articles and reviews, as well as clinically and educationally focused papers on regional best practices. Images, videos, a young psychiatrist''s corner, meeting reports, a journal club and contextual commentaries differentiate this journal from existing main stream psychiatry journals that are focused on other regions, or nationally focused within countries of Asia and the Pacific Rim.

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