社区精神分裂症患者社会支持与生活质量的关联——焦虑抑郁症状为中介的探索性研究  

The association between social support and quality of life in community-dwelling schizophrenia patients:an exploratory study on the mediating role of anxiety and depression symptoms

作　　者：杨琴 巫岚 秦小荣[1] 胡萱怡 熊朝新宇 陈玥 雷小莉 易博 何昌九[1] YANG Qin;WU Lan;QIN Xiao-rong;HU Xuan-yi;XIONG Zhao-xin-yu;CHEN Yue;LEI Xiao-li;YI Bo;HE Chang-jiu(Community Prevention and Treatment Department,Chengdu Fourth People’s Hospital,Chengdu,Sichuan 610081,China;不详)

机构地区：[1]成都市第四人民医院社区防治部,四川成都610081 [2]四川大学华西公共卫生学院/华西第四医院

出　　处：《现代预防医学》2024年第17期3163-3168,3179,共7页Modern Preventive Medicine

基　　金：成都市医学科研课题(2020052)。

摘　　要：目的调查社区精神分裂症患者(简称精分患者)中社会支持、生活质量、焦虑抑郁症状之间的关联与特征以及探索焦虑抑郁症状在社会支持和生活质量之间的中介作用。方法采用多阶段分层整群随机抽样的方法选取出四川省成都市的几个区县共1106例社区精分患者,采用问卷调查的方法进行调查,调查问卷包括社会支持量表(SSRS)、抑郁症筛查量表(PHQ-9)、广泛性焦虑自评量表(GAD-7)、生活质量(QOL)评价,先对精分患者的人口学资料和精神疾病相关信息进行统计描述,再对精分患者生活质量、社会支持总分及焦虑、抑郁得分的相关性分析,最后采用bootstrap法对焦虑抑郁症状在社会支持影响生活质量进行中介分析。结果本次调查获得有效问卷1087份。社区精分患者生活质量躯体健康总分(72.01±20.99)分,心理健康总分(71.68±19.38)分,社会支持总分为(28.27±7.08)分,焦虑症状得分为(3.14±4.39)分,抑郁症状得分为(4.61±5.05)分。Pearson相关分析结果显示,社区精分患者社会支持总分与生活质量的躯体健康和心理健康两个维度得分均呈正相关(P<0.05),与焦虑、抑郁得分呈现负相关(P<0.05)。焦虑和抑郁得分与生活质量的两个维度均呈现负相关关系(P<0.05)。中介效应模型显示,抑郁在社会支持总分影响躯体健康和心理健康中均起到完全中介的作用,中介效应占比分别为33.60%(P<0.01)和47.81%(P<0.01)。焦虑在社会支持总分对于生活质量的影响中的中介效应不显著。结论早期识别出患者的抑郁症状,建立广泛的社会支持,降低患者负面情绪,并采取措施积极地改善病情,促进患者生活质量的提高。Objective To investigate the associations and characteristics among social support,quality of life,and anxiety and depression symptoms in community-dwelling schizophrenia patients,as well as to explore the mediating role of depression and anxiety symptoms between social support and quality of life.Methods A multi-stage stratified cluster random sampling method was employed to select a total of 1106 community schizophrenia patients from several districts and counties in Chengdu,Sichuan Province.A questionnaire survey was conducted,which included the Social Support Rating Scale(SSRS),Patient Health Questionnaire-9(PHQ-9)for depression screening,Generalized Anxiety Disorder-7(GAD-7)for anxiety self-assessment,and Quality of Life(QOL)assessment.Demographic data and information related to mental disorders were statistically described,followed by correlation analysis of quality of life,total social support scores,and anxiety and depression scores.Finally,the Bootstrap method was used to analyze the mediating effects of anxiety and depression symptoms in the relationship between social support and quality of life.Results A total of 1087 valid questionnaires were obtained.The total score for physical health quality of life among community schizophrenia patients was(72.01±20.99),for mental health was(71.68±19.38),and the total social support score was(28.27±7.08).Anxiety symptoms scored(3.14±4.39)and depression symptoms scored(4.61±5.05).Pearson correlation analysis indicated that the total social support score was positively correlated with both physical and mental health quality of life dimensions(P<0.05)and negatively correlated with anxiety and depression scores(P<0.05).Anxiety and depression scores were negatively correlated with both dimensions of quality of life(P<0.05).The mediating effect model showed that depression fully mediated the relationship between total social support and both physical and mental health,with mediation effect proportions of 33.60%(P<0.01)and 47.81%(P<0.01),respectively.The mediating

关 键 词：精神分裂症 社会支持 生活质量 焦虑抑郁 中介效应 

分 类 号：R749.3[医药卫生—神经病学与精神病学]