정신분열병 환자에서의 主觀的 症狀 평가 및 척도의 개발

Assessment of the Subjective Symptoms in Schizophrenic Patients

The purposes of this research are 1) to develop a valid and reliable rating scale to assess the subjective symptoms of the Korean schizophrenic patients, 2) to identify frequently experienced subjective symptoms among Korean schizophrenic and neurotic patients, 3) to test the clinical usefulness of the developed rating scale in discriminating schizophrenics from neurotic patients, and 4) to investigate the relationship between subjective and objective symptoms of schizophrenics. The Subjective Symptom Rating Scale with 35 items was develpoed through preliminary studies, and semi-structured interview was done with 60 remitted schizophrenic patients (by DSM-III-R) and 30 neurotic patients. The results are following ; 1) The schizophrenic patients are experiencing various subjective symptoms and the remitted patients can report them reliably. 2) The inter-rater reliability of the rating scale was 0.78, and the test-retest reliability was 0.81. The Cronbach alpha for internal consistency was 0.8706 and 0.8121 for the schizophrenic and the neurotic patients, respectively. 3) At least 30% of the schizophrenic patients reported that they have frequently or continuously experienced all except 3 items and at least 50% of the schizophrenic patients have reported that they have frequently or continuously experienced 19 items among 35 items(54.3%). 4) 27 items were experienced more frequently by the schizophrenics than the neurotic patients. 5) The items with high correlations with the objective symptoms such as emotional bluting, avolition and social withdrawal were extracted. 6) The 13 items with high discriminat function coefficient were extracted. The methodological issues and the influence of the illness factors in assessing the subjective symptoms of the schizophrenics were discussed. The usefulness of the subjective symptoms in clinical practice and research of the schizophrenia was discussed