社区精神分裂症患者精神病性症状的网络分析
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上海交通大学2024年度“医工交叉研究基金”重点项目( YG2024ZD24);上海交通大 学“交大之星”计划医工交叉研究基金青年项目( YG2025QNA11);上海市科学技术委员会“科技创 新行动计划”医学创新研究领域项目( 24Y22800501、24Y22800503);上海市加强公共卫生体系建设三年行动计划(2023-2025年)学科带头人项目( GWVI-11.2-XD25);上海交通大学文科青年人才培育计划项 目( 2023QN038);2025年“复旦-闵行”健康联合体科研项目( 2025FM03);上海交通大学中国医院发展研 究院2024年度医院管理建设项目( CHDI-2024-A-16); 上海市精神卫生中心院级课题项目( 2023-YJ06)


Network analysis of psychotic symptoms in community-dwelling patients with schizophrenia
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    摘要:

    目的 探究社区精神分裂症患者不同精神病性症状之间的关系,为精神分裂症临床干预 措施的制定提供依据。方法 选取2022 年1—12 月上海市4 个区的631 例社区精神分裂症患者为研究 对象。通过问卷调查收集基本信息,采用简明精神病评定量表(BPRS)评估患者的精神病性症状。采 用网络分析的方法构建症状网络,进行网络估计、中心性及稳定性分析来探究疾病症状之间的关联。 结果 纳入的患者中男性278 例(44.06%,278/631),大专/ 本科及以上[247 例(39.14%,247/631)]、已婚 [295 例(46.75%,295/631)]、非在业[430 例(68.15%,430/631)]和服用抗精神病药物[610 例(96.67%, 610/631)]比例较高,精神病性症状中焦虑症状发生率最高,占45.96%(290/631)。在症状网络中,“关心 躯体健康”和“焦虑”关联最紧密,正则化偏相关系数为0.381;“奇特行为姿势”强度和接近性指数最 高,分别为1.486 和2.002;“奇特行为姿势”和“情感交流障碍”中介性最高,均为2.151;“奇特行为姿势” 和“不寻常思维内容”预期影响指数最高,分别为1.581 和1.576,是网络中的核心节点。结论 社区精 神分裂症患者精神病性症状间存在复杂关联网络,“奇特行为姿势”和“不寻常思维内容”是患者的核 心症状,提示未来医护人员可基于核心症状制定精准化干预策略,预防疾病复发,促进患者康复。

    Abstract:

    Objective To explore the relationship among different psychotic symptoms in communitydwelling patients with schizophrenia, so as to provide a basis for the development of clinical interventions for schizophrenia. Methods A total of 631 community-dwelling schizophrenia patients from four districts in Shanghai between January and December 2022 were selected as study subjects, and basic information was collected through questionnaires. The Brief Psychiatric Rating Scale( BPRS) was used to assess patients' psychotic symptoms. Network analysis was used to construct symptom networks and perform network estimation, centrality, and stability analysis to investigate the relationships among disease symptoms. Results Among the enrolled patients, 278 were male( 44.06%,278/631); a relatively high proportion had a college/undergraduate degrees or above[ 247 cases( 39.14%,247/631)], were married[ 295 cases( 46.75%,295/631)], were unemployed[ 430 cases( 68.15%,430/631)], and were taking antipsychotic medications[ 610 cases( 96.67%, 610/631)]. The incidence of anxiety symptoms was the highest among psychotic symptoms, accounting for 45.96%( 290/631). In the symptom network, "somatic concern" and "anxiety" were most closely associated, with a normalized partial correlation coefficient of 0.381; "mannerism and posturing" had the highest intensity and proximity, at 1.486 and 2.002, respectively; "mannerism and posturing" and "emotional withdrawal" had the highest mediating effects, both at 2.151; "mannerism and posturing" and "unusual thought content" had the highest expected impact indices, at 1.581 and 1.576, respectively, making them core nodes in the network. Conclusions There is a complex network of associations among psychotic symptoms in community-dwelling patients with schizophrenia. "Mannerism and posturing" and "unusual thought content" are the core symptoms of patients, suggesting that future healthcare professionals can develop precise intervention strategies based on the core symptoms to prevent disease recurrence and promote patient recovery.

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杨琛瑶,刘彦丽,王潇兰,等.社区精神分裂症患者精神病性症状的网络分析[J].神经疾病与精神卫生,2026,26(6):404-411. DOI:10.3969/j. issn.1009-6574.2026.06.004.

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  • 在线发布日期: 2026-06-22