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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16.	田银娣, 王怡恺, 李静, 等. 焦虑和抑郁量表在肝硬化患者临床应用中的信效度评价. 实用肝脏病杂志, 2019, 22(1): 105-108.
17.	解亚宁. 简易应对方式量表信度和效度的初步研究. 中国临床心理学杂志, 1998(2): 53-54.
18.	吴莉娟, 王佳宁, 齐晓栋. 简版无法忍受不确定性量表在中学生中应用的效度和信度. 中国心理卫生杂志, 2016, 30(9): 700-705.
19.	张燕丽, 罗珊霞, 李欣, 等. 术后肾移植患者创伤后应激障碍现状及其影响因素. 现代临床护理, 2018, 17(6): 30-34.
20.	陈辉, 张虹. 体外循环心脏手术患者创伤后应激障碍及其影响因素分析. 心血管康复医学杂志, 2019, 28(1): 21-25.
21.	邵勤文. ICU 后综合征心理功能障碍的现状及影响因素分析. 沈阳: 中国医科大学, 2021.
22.	彭建燕, 吴冬梅, 杨海军, 等. 精神疾病患者保护性约束使用的现况调查. 上海护理, 2021, 21(5): 43-45.
23.	沈子晨, 杨正霞, 江海娇, 等. 产后创伤后应激障碍现状及影响因素分析. 现代医药卫生, 2022, 38(10): 1682-1686, 1692.
24.	陈秀芹, 应佳丽, 黄丽妹, 等. 上海市初中生暴力电子游戏对攻击性行为的影响. 中国学校卫生, 2021, 42(8): 1184-1188.
25.	Tedeschi R, Calhoun L. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol, 2004, 15(1): 1-18.
26.	王少凤, 何向材, 李金津, 等. 无法忍受不确定性对急性应激水平的影响: 反刍的中介作用和媒体暴露时间的调节作用//中国心理学会. 第二十三届全国心理学学术会议摘要集. 呼和浩特: 中国心理学会, 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, 吴海苏. 无法忍受不确定性的磁共振研究进展. 神经疾病与精神卫生, 2021, 21(6): 438-441.
29.	秦天翔. 青年群体成人依恋、自尊和无法忍受不确定性之间的关系研究. 上海: 上海师范大学, 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. 张传福, 黄海锋, 周强. 癸酸氟哌啶醇注射液对慢性精神分裂症的疗效观察. 黑龙江医药, 2020, 33(6): 1338-1339.
6. 郭城伟, 周娇娇, 冯媛, 等. 精神分裂症患者与正常人自尊水平的对照研究. 首都医科大学学报, 2022, 43(2): 294-298.
7. 范肖冬, 等, 译. ICD-10 精神与行为障碍分类: 临床描述与诊断要点. 北京: 人民卫生出版社, 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, 王铁虎. 复发性精神分裂症患者生活质量状况调查及影响因素分析. 中华全科医学, 2022, 20(5): 821-823, 858.
10. 郭素然, 辛自强, 耿柳娜. 事件影响量表修订版的信度和效度分析. 中国临床心理学杂志, 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. 吴晓珺, 王士良, 何艳宏, 等. 事件影响量表修订版在新冠肺炎疫情下隔离人群中的信效度分析. 中国临床心理学杂志, 2020, 28(4): 760-762.
13. 刘杉文, 叶存春. 后疫情时代公众的心理应激反应及其应对方式研究. 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. 刘新良. 抑郁自评量表在抑郁症诊断中的应用. 中国航天工业医药, 2001, 3(6): 39-40.
16. 田银娣, 王怡恺, 李静, 等. 焦虑和抑郁量表在肝硬化患者临床应用中的信效度评价. 实用肝脏病杂志, 2019, 22(1): 105-108.
17. 解亚宁. 简易应对方式量表信度和效度的初步研究. 中国临床心理学杂志, 1998(2): 53-54.
18. 吴莉娟, 王佳宁, 齐晓栋. 简版无法忍受不确定性量表在中学生中应用的效度和信度. 中国心理卫生杂志, 2016, 30(9): 700-705.
19. 张燕丽, 罗珊霞, 李欣, 等. 术后肾移植患者创伤后应激障碍现状及其影响因素. 现代临床护理, 2018, 17(6): 30-34.
20. 陈辉, 张虹. 体外循环心脏手术患者创伤后应激障碍及其影响因素分析. 心血管康复医学杂志, 2019, 28(1): 21-25.
21. 邵勤文. ICU 后综合征心理功能障碍的现状及影响因素分析. 沈阳: 中国医科大学, 2021.
22. 彭建燕, 吴冬梅, 杨海军, 等. 精神疾病患者保护性约束使用的现况调查. 上海护理, 2021, 21(5): 43-45.
23. 沈子晨, 杨正霞, 江海娇, 等. 产后创伤后应激障碍现状及影响因素分析. 现代医药卫生, 2022, 38(10): 1682-1686, 1692.
24. 陈秀芹, 应佳丽, 黄丽妹, 等. 上海市初中生暴力电子游戏对攻击性行为的影响. 中国学校卫生, 2021, 42(8): 1184-1188.
25. Tedeschi R, Calhoun L. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol, 2004, 15(1): 1-18.
26. 王少凤, 何向材, 李金津, 等. 无法忍受不确定性对急性应激水平的影响: 反刍的中介作用和媒体暴露时间的调节作用//中国心理学会. 第二十三届全国心理学学术会议摘要集. 呼和浩特: 中国心理学会, 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, 吴海苏. 无法忍受不确定性的磁共振研究进展. 神经疾病与精神卫生, 2021, 21(6): 438-441.
29. 秦天翔. 青年群体成人依恋、自尊和无法忍受不确定性之间的关系研究. 上海: 上海师范大学, 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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