統合失調症者の「心の理論」における他者の意図の推論機能と精神症状の関連

The Relationship of the Inferential Function of the Intentions of Others in the "Theory of Mind" With Psychiatric Symptoms in Schizophrenics

要旨

　目的：統合失調症者は，他者の言動の意図の理解に困難を示すことがあり，対人交流上の問題を引き起こす可能性がある．本研究では，他者の意図の推論機能と精神症状との関連を明らかにすることを目的とした．

　方法：入院中の統合失調症者45名を対象として構造的面接調査を行った．他者の意図の推論はヒント課題，精神症状はPANSSにて評価した．

　結果：ヒント課題の「願望」の課題の得点が1.67〜1.80であり，「怒り」「皮肉」の課題の得点は0.73〜1.60であった．ヒント課題合計点とPANSSの「概念の統合障害」（r＝-.58），「常同的思考」（r＝-.53）において関連が認められた．

　結論：統合失調症者は，怒りや皮肉のような二次感情を理解することが難しく，思路障害や内的な体験による思考が強い場合に他者の意図の推論が困難になる傾向があると考えられた．

　Objectives: Schizophrenics may exhibit difficulties in understanding the intentions of others' words and actions, which may cause problems in their interpersonal interactions. This study aimed to clarify the relationship of the inferential function of the intentions of others with psychiatric symptoms in schizophrenics.

　Methods: A structured interview survey was conducted with 45 hospitalized schizophrenics. The inference of others' intentions was assessed using the Hinting task, and psychiatric symptoms were assessed via the Positive and Negative Syndrome Scale (PANSS).

　Results: Scores on "desire" task ranged from 1.67 to 1.80, and scores on "anger" and "sarcasm" tasks ranged from 0.73 to 1.60. An association was found between total the Hinting task scores and PANSS scores for "conceptual disorganization" (r＝-.58) and "stereotyped thinking" (r＝-.53).

　Conclusion: This study found that schizophrenics experience difficulty in understanding secondary emotions such as anger and sarcasm. Particularly, those who had a thought disorder or thinking through internal experiences tended to exhibit difficulty in inferring the intentions of others.