Status and influencing factors of psychosis-related post-traumatic stress disorder in hospitalized patients with schizophrenia_West China Medical Journal

Authors：

MA Xiucheng ¹ , HOU Xiaofeng ¹ , YANG Cui ¹ , JIAN Na ² , YAN Mao ³ , GAN Qianjiao ⁴ , TANG Xiaowei ⁵ ,  WU Dongmei ⁶

1. School of Nursing, Chengdu Medical College, Chengdu, Sichuan 610083, P. R. China;
2. Nursing Department, Chengdu Jinxin Psychiatric Hospital, Chengdu, Sichuan 610011, P. R. China;
3. Nursing Department, Dujiangyan Mental Health Center, Chengdu, Sichuan 611830, P. R. China;
4. Nursing Department, the Fourth People’s Hospital of Pengzhou, Chengdu, Sichuan 611900, P. R. China;
5. Psychiatric Rehabilitation Department, the Fourth People’s Hospital of Pengzhou, Chengdu, Sichuan 611900, P. R. China;
6. Nursing Department, the Fourth People’s Hospital of Chengdu, Chengdu, Sichuan 610036, P. R. China;

Corresponding?author：

WU Dongmei, Email: wudongmei_2001@163.com

Keywords：

Schizophrenia; post-traumatic stress disorder; influencing factors

DOI：

10.7507/1002-0179.202208021

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Objective To investigate the status and influencing factors of psychosis-related post-traumatic stress disorder (PR-PTSD) in hospitalized patients with schizophrenia. Methods A questionnaire survey was conducted among the hospitalized patients with schizophrenia in three grade Ⅱ or above psychiatric hospitals in Chengdu between March and July, 2022, using the convenient sampling method. Questionnaires included the General Information Questionnaire, Impact of Event Scale-revised (IES-R), Self-rating Depression Scales, Simplified Coping Style Questionnaire, and Intolerance of Uncertainty Scale. If the score showed skewed distribution, it was expressed by the median (lower quartile, upper quartile). According to IES-R score, the patients included were divided into 2 groups. The patients whose score ≥33 were divided into PR-PTSD group, and <33 were divided into non-PR-PTSD group. The general information of the two groups of patients were compared. The correlation between PR-PTSD and depression, coping style and intolerance of uncertainty of the included patients were analyzed. The factors affecting the PR-PTSD of hospitalized patients with schizophrenia were analyzed by multivariate binary logistic regression analysis. Results A total of 388 patients were included. Among them, there were 282 cases in the non-PR-PTSD group and 106 cases in the PR-PTSD group. The IES-R score was 23.00 (15.00, 33.00), the depression score was 45.00 (38.00, 53.00), the negative coping style score was 11.00 (8.00, 14.75), the positive coping style score was 20.00 (16.00, 25.00), and the intolerance of uncertainty score was 28.00 (22.25, 33.00). IES-R was positively correlated with depression (r=0.370, P<0.001), negative coping style (r=0.396, P<0.001), positive coping style (r=0.111, P=0.029) and intolerance of uncertainty (r=0.467, P<0.001). Regression analysis showed that depression [(odds ratio, OR)=1.073, 95% confidence interval (CI) (1.043, 1.105), P<0.001)], negative coping style [OR=1.121, 95%CI (1.040, 1.208), P=0.003], intolerance of uncertainty [OR=1.081, 95%CI (1.045, 1.118), P<0.001] were the influencing factors of PR-PTSD in hospitalized patients with schizophrenia. Conclusions The prevalence of PR-PTSD in hospitalized patients with schizophrenia is high. Depression, negative coping style and intolerance of uncertainty are the risk factors for PR-PTSD in hospitalized schizophrenia patients.

Citation： MA Xiucheng, HOU Xiaofeng, YANG Cui, JIAN Na, YAN Mao, GAN Qianjiao, TANG Xiaowei, WU Dongmei. Status and influencing factors of psychosis-related post-traumatic stress disorder in hospitalized patients with schizophrenia. West China Medical Journal, 2023, 38(4): 574-580. doi: 10.7507/1002-0179.202208021 Copy

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2.	Berry K, Ford S, Jellicoe-Jones L, et al. PTSD symptoms associated with the experiences of psychosis and hospitalisation: a review of the literature. Clin Psychol Rev, 2013, 33(4): 526-538.
3.	Abdelghaffar W, Ouali U, Jomli R, et al. Posttraumatic stress disorder in first-episode psychosis: prevalence and related factors. Clin Schizophr Relat Psychoses, 2018, 12(3): 105-112B.
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12.	吳曉珺, 王士良, 何艷宏, 等. 事件影響量表修訂版在新冠肺炎疫情下隔離人群中的信效度分析. 中國臨床心理學雜志, 2020, 28(4): 760-762.
13.	劉杉文, 葉存春. 后疫情時代公眾的心理應激反應及其應對方式研究. 心理月刊, 2021, 16(6): 19-20, 73.
14.	Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale-revised. Behav Res Ther, 2003, 41(12): 1489-1496.
15.	劉新良. 抑郁自評量表在抑郁癥診斷中的應用. 中國航天工業醫藥, 2001, 3(6): 39-40.
16.	田銀娣, 王怡愷, 李靜, 等. 焦慮和抑郁量表在肝硬化患者臨床應用中的信效度評價. 實用肝臟病雜志, 2019, 22(1): 105-108.
17.	解亞寧. 簡易應對方式量表信度和效度的初步研究. 中國臨床心理學雜志, 1998(2): 53-54.
18.	吳莉娟, 王佳寧, 齊曉棟. 簡版無法忍受不確定性量表在中學生中應用的效度和信度. 中國心理衛生雜志, 2016, 30(9): 700-705.
19.	張燕麗, 羅珊霞, 李欣, 等. 術后腎移植患者創傷后應激障礙現狀及其影響因素. 現代臨床護理, 2018, 17(6): 30-34.
20.	陳輝, 張虹. 體外循環心臟手術患者創傷后應激障礙及其影響因素分析. 心血管康復醫學雜志, 2019, 28(1): 21-25.
21.	邵勤文. ICU 后綜合征心理功能障礙的現狀及影響因素分析. 沈陽: 中國醫科大學, 2021.
22.	彭建燕, 吳冬梅, 楊海軍, 等. 精神疾病患者保護性約束使用的現況調查. 上海護理, 2021, 21(5): 43-45.
23.	沈子晨, 楊正霞, 江海嬌, 等. 產后創傷后應激障礙現狀及影響因素分析. 現代醫藥衛生, 2022, 38(10): 1682-1686, 1692.
24.	陳秀芹, 應佳麗, 黃麗妹, 等. 上海市初中生暴力電子游戲對攻擊性行為的影響. 中國學校衛生, 2021, 42(8): 1184-1188.
25.	Tedeschi R, Calhoun L. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol, 2004, 15(1): 1-18.
26.	王少鳳, 何向材, 李金津, 等. 無法忍受不確定性對急性應激水平的影響: 反芻的中介作用和媒體暴露時間的調節作用//中國心理學會. 第二十三屆全國心理學學術會議摘要集. 呼和浩特: 中國心理學會, 2021: 3.
27.	White RG, Gumley AI. Postpsychotic posttraumatic stress disorder: associations with fear of recurrence and intolerance of uncertainty. J Nerv Ment Dis, 2009, 197(11): 841-849.
28.	丁青梅, 吳海蘇. 無法忍受不確定性的磁共振研究進展. 神經疾病與精神衛生, 2021, 21(6): 438-441.
29.	秦天翔. 青年群體成人依戀、自尊和無法忍受不確定性之間的關系研究. 上海: 上海師范大學, 2021.

1. Rodrigues R, Anderson KK. The traumatic experience of first-episode psychosis: a systematic review and meta-analysis. Schizophr Res, 2017, 189: 27-36.
2. Berry K, Ford S, Jellicoe-Jones L, et al. PTSD symptoms associated with the experiences of psychosis and hospitalisation: a review of the literature. Clin Psychol Rev, 2013, 33(4): 526-538.
3. Abdelghaffar W, Ouali U, Jomli R, et al. Posttraumatic stress disorder in first-episode psychosis: prevalence and related factors. Clin Schizophr Relat Psychoses, 2018, 12(3): 105-112B.
4. Buswell G, Haime Z, Lloyd-Evans B, et al. A systematic review of PTSD to the experience of psychosis: prevalence and associated factors. BMC Psychiatry, 2021, 21(1): 9.
5. 張傳福, 黃海鋒, 周強. 癸酸氟哌啶醇注射液對慢性精神分裂癥的療效觀察. 黑龍江醫藥, 2020, 33(6): 1338-1339.
6. 郭城偉, 周嬌嬌, 馮媛, 等. 精神分裂癥患者與正常人自尊水平的對照研究. 首都醫科大學學報, 2022, 43(2): 294-298.
7. 范肖冬, 等, 譯. ICD-10 精神與行為障礙分類: 臨床描述與診斷要點. 北京: 人民衛生出版社, 1993.
8. Fornells-Ambrojo M, Gracie A, Brewin CR, et al. Narrowing the focus on the assessment of psychosis-related PTSD: a methodologically orientated systematic review. Eur J Psychotraumatol, 2016, 7: 32095.
9. 余林花, 王鐵虎. 復發性精神分裂癥患者生活質量狀況調查及影響因素分析. 中華全科醫學, 2022, 20(5): 821-823, 858.
10. 郭素然, 辛自強, 耿柳娜. 事件影響量表修訂版的信度和效度分析. 中國臨床心理學雜志, 2007, 15(1): 15-17.
11. Bendall S, Alvarez-Jimenez M, Hulbert CA, et al. Childhood trauma increases the risk of post-traumatic stress disorder in response to first-episode psychosis. Aust N Z J Psychiatry, 2012, 46(1): 35-39.
12. 吳曉珺, 王士良, 何艷宏, 等. 事件影響量表修訂版在新冠肺炎疫情下隔離人群中的信效度分析. 中國臨床心理學雜志, 2020, 28(4): 760-762.
13. 劉杉文, 葉存春. 后疫情時代公眾的心理應激反應及其應對方式研究. 心理月刊, 2021, 16(6): 19-20, 73.
14. Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale-revised. Behav Res Ther, 2003, 41(12): 1489-1496.
15. 劉新良. 抑郁自評量表在抑郁癥診斷中的應用. 中國航天工業醫藥, 2001, 3(6): 39-40.
16. 田銀娣, 王怡愷, 李靜, 等. 焦慮和抑郁量表在肝硬化患者臨床應用中的信效度評價. 實用肝臟病雜志, 2019, 22(1): 105-108.
17. 解亞寧. 簡易應對方式量表信度和效度的初步研究. 中國臨床心理學雜志, 1998(2): 53-54.
18. 吳莉娟, 王佳寧, 齊曉棟. 簡版無法忍受不確定性量表在中學生中應用的效度和信度. 中國心理衛生雜志, 2016, 30(9): 700-705.
19. 張燕麗, 羅珊霞, 李欣, 等. 術后腎移植患者創傷后應激障礙現狀及其影響因素. 現代臨床護理, 2018, 17(6): 30-34.
20. 陳輝, 張虹. 體外循環心臟手術患者創傷后應激障礙及其影響因素分析. 心血管康復醫學雜志, 2019, 28(1): 21-25.
21. 邵勤文. ICU 后綜合征心理功能障礙的現狀及影響因素分析. 沈陽: 中國醫科大學, 2021.
22. 彭建燕, 吳冬梅, 楊海軍, 等. 精神疾病患者保護性約束使用的現況調查. 上海護理, 2021, 21(5): 43-45.
23. 沈子晨, 楊正霞, 江海嬌, 等. 產后創傷后應激障礙現狀及影響因素分析. 現代醫藥衛生, 2022, 38(10): 1682-1686, 1692.
24. 陳秀芹, 應佳麗, 黃麗妹, 等. 上海市初中生暴力電子游戲對攻擊性行為的影響. 中國學校衛生, 2021, 42(8): 1184-1188.
25. Tedeschi R, Calhoun L. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol, 2004, 15(1): 1-18.
26. 王少鳳, 何向材, 李金津, 等. 無法忍受不確定性對急性應激水平的影響: 反芻的中介作用和媒體暴露時間的調節作用//中國心理學會. 第二十三屆全國心理學學術會議摘要集. 呼和浩特: 中國心理學會, 2021: 3.
27. White RG, Gumley AI. Postpsychotic posttraumatic stress disorder: associations with fear of recurrence and intolerance of uncertainty. J Nerv Ment Dis, 2009, 197(11): 841-849.
28. 丁青梅, 吳海蘇. 無法忍受不確定性的磁共振研究進展. 神經疾病與精神衛生, 2021, 21(6): 438-441.
29. 秦天翔. 青年群體成人依戀、自尊和無法忍受不確定性之間的關系研究. 上海: 上海師范大學, 2021.

West China Medical Journal

Status and influencing factors of psychosis-related post-traumatic stress disorder in hospitalized patients with schizophrenia

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