精神分裂症住院病人性別與症狀

Gendered Symptomatology in Inpatients with Schizophrenia

10.29478/TJP.200712.0004

李冠瑩(Kuan-Ying Lee)；陳映燁(Ying-Yen Chen,)；李仁欽(Jen-Chin Lee)

妄想內容 ； 性別差異 ； 症狀學 ； content of delusion ； sex differences ； symptomatology

台灣精神醫學

21卷4期（2007 / 12 / 01）

263 - 270

繁體中文

目的：了解精神分裂症住院病人症狀學之性別差異。方法：收集自民國93年7月至民國94年6月間，某精神科專科醫院急性病房住院病人中，符合DSM-IV精神分裂症診斷之病人共254人（男性118位，女性136位），以回溯性病歷回顧的方式，紀錄病患妄想內容，先以描述性分析的方式評估其性別分佈，再以卡方檢定評估妄想內容之性別差異是否有意義。結果：女性精神分裂症病患有較高比率的忌妒/情慾妄想（男性7.6%vs.女性19.9%，p=0.006）。然被害妄想、關係妄想、政治妄想、誇大妄想、宗教妄想、錯認妄想以及虛無妄想皆無性別差異，但在迫害對象(persecutor)方面，女性病患的迫害者有較高的比率是重要關係人(31.7%vs. 51.8%; p=0.015)。自殺與暴力攻擊史方面，女性病患的自殺想法（排除掉自殺/自傷行為）比例顯著高於男性病人(12.5%vs. 4.2%; p=0.024)；男性病人則有較高比例有暴力攻擊史(68.6%vs.51.5%;p=0.007)，且攻擊陌生人的比例較女性高(23.5%vs. 4.3%; p=0.001)。住院過程中，男性病人有較高的比例因病情需要轉加護病房(16.2%vs. 5.3%; p=0.006)。結論：精神分裂症病人之妄想內容、自殺／自傷史、住院過程及處置會隨性別而有所差異。

Objective: To examine gender differences in symptomatology among schizophrenic inpatients. Methods: A retrospective chart review was performed and 254 (11 8male, 136 female) schizophrenic inpatients admitted to a regional psychiatric institute between July 1, 2004 and June, 30, 2005 were enrolled. Information on socio-demographic factors, delusional contents, history of suicide/homicide and symptom severity were collected using a standardized coding sheet. Student t-test and chi-square analyses were used to compare gender differences. Results: Female subjects experienced more jealous/erotic delusions compared to their male counterparts. (male 7.6% vs. female 19.9%, p=0.006) Furthermore, female patients tended to identify their significant others as persecutors (p=0.015). Female schizophrenic patients were more likely to report past suicidal ideations, whereas male patients reported more violent episodes. As for treatment, on admission, male subjects were more likely to be transferred to intensive care units, however, other interventions such as intramuscular injection of antipsychotics, physical restraints and electroconvulsive treatment did not differ by gender: Conclusions: We conclude that there are gender differences in the content of delusions, suicide/violence history, and treatment interventions among schizophrenia patients.

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