統合失調症の病識と抑うつおよび心理社会的要因との関連

The Relationship between a Patient's Awareness of Disease, Depression, and Other Psychosocial Factors in Schizophrenia

抄録

　統合失調症の病識は，陽性・陰性症状や抑うつなどの精神症状だけでなく，主観的ウェルビーイングやセルフスティグマなどの心理社会的要因とも関連するといわれている。本研究では，外来患者の病識を定量的に調査し，各要因との関連について検討した。その結果，抑うつや心理社会的要因と強く関連する病識の下位尺度は「自己の疾病への意識」であり，特に，意識する頻度が抑うつと主観的ウェルビーイングに対して大きな影響を与えることが示唆された。疾病教育とともに適応能力や自信を高める支援が行われないと，病識の高まりとともに抑うつ感も高まる危険性が示唆された。

　Recent research has indicated that a schizophrenic patient's awareness of the disease is associated not only with depression and positive/negative syndrome, but also subjective well-being and self-stigma. To explore the relationship between awareness of the disease and such elements, we interviewed 64 patients diagnosed with schizophrenia. Significant associations were found between "awareness of illness" and depression/subjective well-being. In addition, we found that the frequency that patients recognize themselves as psychosis was associated with depression and subjective well-being. These findings suggest that psychoeducation should be combined with programs that will help the patients to improve their level of self-efficacy because psychoeducation alone can have negative effects on their depressive state and subjective well-being.