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정신분열증 환자의 주관적 음성증상경험의 임상적 의의

Other Titles
 A Clinical Significance of the Subjective Experiences of Negative Symptoms in the Patients with Schizophrenia 
Authors
 김지웅  ;  김찬형  ;  구민성  ;  손석한  ;  박진철  ;  최문종  ;  이은철  ;  윤도준  ;  이홍식 
Citation
 Journal of the Korean Neuropsychiatric Association (신경정신의학), Vol.38(1) : 128-138, 1999 
Journal Title
Journal of the Korean Neuropsychiatric Association(신경정신의학)
ISSN
 1015-4817 
Issue Date
1999
Abstract
Objective:Since the evaluation of negative symptoms has depended on the clinician’s objective
observation, the patients’ subjective experience of negative symptoms has been neglected. However, in
fact, a lot of patients are aware of their negative symptoms. There are several reports suggesting that
patients suffer from the subjective experiences of their deficit symptoms, even though the objective
positive and negative symtoms cannot be observed. Under these circumstances, we have attempted this
study with the idea that it would be helpful in understanding the psychopathology of schizophrenia.
Also it would help clarifying the relationship between subjective experience of negative symptoms and
objective positive and negative symptoms, depression, anxiety symptoms, and extrapyramidal symptoms.
Method:All the 37 patients satisfied the diagnostic criteria of DSM-IV for schizophrenia . The
subjective experiences of negative symptoms were evaluated using Scale for the Subjective Experience
of Negative Symptoms, Korean version(K-SENS), and for the depression, anxiety, extrapyramidal symptoms,
we used Hamilton Rating Scale for Depression(HAM-D), Hamilton Rating Scale for Anxiety
(HAM-A), and Extrapyramidal Symptom Rating Scale(ESRS). The correlation between each psychopathology
was tested by calculating Spearman correlation coefficient.
Results:There was a significant correlation between the ratio of items experienced as uncomfortable
symptoms among 24 items of K-SENS, and the score of PANSS positive subscale(γ=-0.40, p<0.
05). Among the positive symptoms, grandiosity(γ=-0.46, p<0.05), suspiciousnes/persecution(γ=-0.34,
p<0.05), and hostility(γ=-0.52, p<0.05) showed a significant correlation with the ratio of items experienced
as uncomfortable symptoms among 24 items of K-SENS. There was no significant correlation
between the ratio of items experienced as uncomfortable symptoms among 24 items of K-SENS, and
PANSS total score(γ=-0.25, p>0.05), or negative subscale score(γ=-0.20, p>0.05), or general psychopathology
subscale score(γ=-0.08, p>0.05), respectively. There was no significant correlation between
the ratio of items experienced as uncomfortable symptoms among 24 items of K-SENS, and
HAM-D(γ=-0.01, p>0.05), or HAM-A(γ=-0.11, p>0.05), ESRS(γ=0.34. p>0.05), respectively.
Conclusion:These results revealed that the negative correlation between the subjective negative
symptoms experienced as an uncomfortable ones and the objective positive symptoms such as grandiosity,
suspiciousness/persecution, and hostility. From these results, the possibility that positive symptoms
are used as a defense to hide from the subjectively experienced negative symptoms, or that patients may
not be aware of their negative symptoms because they are overwhelmed by their positive symtpoms. is
suggested. These results also suggest that subjective experiences of negative symptoms are independent
from depression, anxiety and extrapyramidal symptoms
Files in This Item:
T199903068.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chan Hyung(김찬형)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/172890
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