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在精神病的过程中,洞察力是否会提高?
Pegah Seif1, Elisabetta Claudia Del Re2, Carol A Tamminga3
1Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA.
Schizophrenia research
|November 21, 2025
概括
在精神分裂症中,洞察力或疾病意识往往很差,特别是在早期. 虽然洞察力随着时间的推移而略有改善,但心理教育等早期干预措施可能会提高患者的参与度.
科学领域:
- 精神病学是一个精神病学.
- 神经科学是一个神经科学.
- 临床心理学 临床心理学
背景情况:
- 精神病障碍中常见的洞察力受损,与症状严重程度和认知功能相关.
- 自诊断以来的洞察力和疾病持续时间之间的关系在不同的精神病障碍中仍然不清楚.
研究的目的:
- 调查洞察力,认知功能和第一次诊断以来的时间之间的关联,在患有精神疾病的患者的大型多诊断样本中.
- 为了比较精神分裂症,精神分裂情绪障碍和双相I型情绪障碍与精神病特征的洞察力水平.
主要方法:
- 研究了957名精神分裂症患者 (SZ),723名精神分裂情绪障碍患者 (SAD) 和691名双相I型精神障碍患者 (BP) 的队列.
- 认知功能使用精神分裂症认知简要评估 (BACS) 电池进行评估.
- 洞察力是通过积极和消极综合征量表 (PANSS) 的项目G12进行测量,较高的分数表明洞察力较差.
主要成果:
- 洞察力因诊断而有显著差异,与SAD和BP相比,精神分裂症的洞察力最差.
- 在精神分裂症中,在第一年内被诊断出患者的洞察力比在3年或更长时间前被诊断出患者的洞察力更差.
- 对精神分裂症的洞察力与诊断以来的时间相对适度,与认知相对弱,并且与积极和消极症状严重程度有很强的相关性. 在SAD或BP中没有发现这种关联.
结论:
- 在精神分裂症中,自诊断以来的更长时间和更好的洞察力之间存在统计学上显著但非常小的关联,在诊断后的第一年观察到的最显著的洞察力缺陷.
- 建议早期,针对诊断的心理教育和以元认知为重点的干预措施,以提高对精神分裂症的洞察力和患者参与度.
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