{"title":"精神分裂症阳性症状缓解的临床和社会人口学关联","authors":"A K Jana","doi":"10.12809/eaap1961","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To determine factors associated with remission from positive symptoms in Indian patients with schizophrenia.</p><p><strong>Methods: </strong>We evaluated 151 patients (99 men and 52 women) aged 18 to 65 years who were diagnosed with schizophrenia and followed up for ≥6 months (with a minimum of two evaluations). We assessed psychopathology, the level of best functioning in the past year, premorbid functioning (up to 1 year), daily living skills, medication adherence, adverse effects to medications, the number of stressful events in the 6 months before illness onset, perceived social support, expressed emotion from family, and personal construct of empowerment. Remission from positive symptoms of schizophrenia was defined as simultaneous attainment of a score of ≤3 (mild) for ≥6 months in the following symptoms: delusions, concept disorganisation, hallucinatory behaviour, unusual thought content, mannerisms, and posturing. Patients were categorised as remitted and non-remitted.</p><p><strong>Results: </strong>Of 151 patients, 81 (53.64%) fulfilled the remission criteria. Compared with non-remitted patients, remitted patients had a shorter duration of untreated psychosis (t = -2.29, p < 0.05), better premorbid functioning in childhood (t = -1.99, p < 0.05) and general (t = -9.34, p < 0.001) subscale, higher medication adherence (t = 6.91, p < 0.001), higher daily living skills ( t = 8.65, p < 0.001), better perceived social support (t = 6.69, p < 0.001), higher empowerment (t = 5.64, p < 0.001), and received higher warmth (t = 1.99, p < 0.05) and lower hostility (t = -4.00, p < 0.001), dissatisfaction (t = -6.96, p < 0.001), and critical comments (t = -2.48, p < 0.05) from family members. Predictors of remission were duration of untreated psychosis (B = -0.020, p < 0.05), daily living skills (B = 2.063, p < 0.001), perceived social support (B = 0.084, p < 0.01), and dissatisfaction from family members (B = -0.621, p < 0.01).</p><p><strong>Conclusions: </strong>53.64% of patients with schizophrenia achieved remission from positive symptoms. Remission was more likely to occur in patients with shorter duration of untreated psychosis, better daily living skills, higher perceived social support, and less dissatisfaction from family members.</p>","PeriodicalId":39171,"journal":{"name":"East Asian Archives of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Clinical and Sociodemographic Associates of Remission from Positive Symptoms in Schizophrenia.\",\"authors\":\"A K Jana\",\"doi\":\"10.12809/eaap1961\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To determine factors associated with remission from positive symptoms in Indian patients with schizophrenia.</p><p><strong>Methods: </strong>We evaluated 151 patients (99 men and 52 women) aged 18 to 65 years who were diagnosed with schizophrenia and followed up for ≥6 months (with a minimum of two evaluations). We assessed psychopathology, the level of best functioning in the past year, premorbid functioning (up to 1 year), daily living skills, medication adherence, adverse effects to medications, the number of stressful events in the 6 months before illness onset, perceived social support, expressed emotion from family, and personal construct of empowerment. Remission from positive symptoms of schizophrenia was defined as simultaneous attainment of a score of ≤3 (mild) for ≥6 months in the following symptoms: delusions, concept disorganisation, hallucinatory behaviour, unusual thought content, mannerisms, and posturing. Patients were categorised as remitted and non-remitted.</p><p><strong>Results: </strong>Of 151 patients, 81 (53.64%) fulfilled the remission criteria. Compared with non-remitted patients, remitted patients had a shorter duration of untreated psychosis (t = -2.29, p < 0.05), better premorbid functioning in childhood (t = -1.99, p < 0.05) and general (t = -9.34, p < 0.001) subscale, higher medication adherence (t = 6.91, p < 0.001), higher daily living skills ( t = 8.65, p < 0.001), better perceived social support (t = 6.69, p < 0.001), higher empowerment (t = 5.64, p < 0.001), and received higher warmth (t = 1.99, p < 0.05) and lower hostility (t = -4.00, p < 0.001), dissatisfaction (t = -6.96, p < 0.001), and critical comments (t = -2.48, p < 0.05) from family members. Predictors of remission were duration of untreated psychosis (B = -0.020, p < 0.05), daily living skills (B = 2.063, p < 0.001), perceived social support (B = 0.084, p < 0.01), and dissatisfaction from family members (B = -0.621, p < 0.01).</p><p><strong>Conclusions: </strong>53.64% of patients with schizophrenia achieved remission from positive symptoms. Remission was more likely to occur in patients with shorter duration of untreated psychosis, better daily living skills, higher perceived social support, and less dissatisfaction from family members.</p>\",\"PeriodicalId\":39171,\"journal\":{\"name\":\"East Asian Archives of Psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"East Asian Archives of Psychiatry\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.12809/eaap1961\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"East Asian Archives of Psychiatry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12809/eaap1961","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
摘要
目的:确定与印度精神分裂症患者阳性症状缓解相关的因素。方法:我们评估了151例(男性99例,女性52例)年龄在18 - 65岁的精神分裂症患者,随访时间≥6个月(至少进行两次评估)。我们评估了精神病理学、过去一年的最佳功能水平、病前功能(长达1年)、日常生活技能、药物依从性、药物不良反应、发病前6个月内压力事件的数量、感知到的社会支持、来自家庭的情感表达和个人赋权的构建。精神分裂症阳性症状的缓解被定义为在以下症状中同时达到≤3分(轻度),持续≥6个月:妄想、概念紊乱、幻觉行为、不寻常的思想内容、举止和姿势。患者分为缓解型和非缓解型。结果:151例患者中,81例(53.64%)达到缓解标准。non-remitted患者相比,免除病人治疗精神病的持续时间较短(t = -2.29, p < 0.05),更好的在儿童时期发病前的功能(t = -1.99, p < 0.05)和通用(t = -9.34, p < 0.001)内部氧化物,提高药物依从性(t = 6.91, p < 0.001),更高的日常生活技能(t = 8.65, p < 0.001),更好的感知到的社会支持(t = 6.69, p < 0.001),更高的权力(t = 5.64, p < 0.001),并得到了更高的温暖(t = 1.99,家庭成员的敌意(t = -4.00, P < 0.001)、不满(t = -6.96, P < 0.001)和批评意见(t = -2.48, P < 0.05)较低。缓解的预测因子为精神病未治疗持续时间(B = -0.020, p < 0.05)、日常生活技能(B = 2.063, p < 0.001)、感知到的社会支持(B = 0.084, p < 0.01)和家庭成员的不满(B = -0.621, p < 0.01)。结论:53.64%的精神分裂症患者阳性症状得到缓解。缓解更可能发生在精神病治疗持续时间较短、日常生活技能较好、感知社会支持较高、家庭成员不满较少的患者身上。
Clinical and Sociodemographic Associates of Remission from Positive Symptoms in Schizophrenia.
Objectives: To determine factors associated with remission from positive symptoms in Indian patients with schizophrenia.
Methods: We evaluated 151 patients (99 men and 52 women) aged 18 to 65 years who were diagnosed with schizophrenia and followed up for ≥6 months (with a minimum of two evaluations). We assessed psychopathology, the level of best functioning in the past year, premorbid functioning (up to 1 year), daily living skills, medication adherence, adverse effects to medications, the number of stressful events in the 6 months before illness onset, perceived social support, expressed emotion from family, and personal construct of empowerment. Remission from positive symptoms of schizophrenia was defined as simultaneous attainment of a score of ≤3 (mild) for ≥6 months in the following symptoms: delusions, concept disorganisation, hallucinatory behaviour, unusual thought content, mannerisms, and posturing. Patients were categorised as remitted and non-remitted.
Results: Of 151 patients, 81 (53.64%) fulfilled the remission criteria. Compared with non-remitted patients, remitted patients had a shorter duration of untreated psychosis (t = -2.29, p < 0.05), better premorbid functioning in childhood (t = -1.99, p < 0.05) and general (t = -9.34, p < 0.001) subscale, higher medication adherence (t = 6.91, p < 0.001), higher daily living skills ( t = 8.65, p < 0.001), better perceived social support (t = 6.69, p < 0.001), higher empowerment (t = 5.64, p < 0.001), and received higher warmth (t = 1.99, p < 0.05) and lower hostility (t = -4.00, p < 0.001), dissatisfaction (t = -6.96, p < 0.001), and critical comments (t = -2.48, p < 0.05) from family members. Predictors of remission were duration of untreated psychosis (B = -0.020, p < 0.05), daily living skills (B = 2.063, p < 0.001), perceived social support (B = 0.084, p < 0.01), and dissatisfaction from family members (B = -0.621, p < 0.01).
Conclusions: 53.64% of patients with schizophrenia achieved remission from positive symptoms. Remission was more likely to occur in patients with shorter duration of untreated psychosis, better daily living skills, higher perceived social support, and less dissatisfaction from family members.