以潛在類別方法評估精神分裂症活性與負性症狀之潛在結構與轉變

Abstract

本研究有兩個主要目的：一是探討精神分裂症之活性與負性症狀評量表(PANSS)的結構，一是深入研究在不同階段下結構的轉變。我們以潛在類別迴歸方法找出219位急性期精神分裂症患者可分為五種類別：混合、負性、解組性思考、妄想及活性/少數混合，並找出225位慢性期精神分裂症患者可區分為四種類別：少數混合、負性、妄想及無症狀，根據研究發現慢性期的症狀結構是附屬在急性症狀期的症狀結構之下。另外，以潛在變遷分析探討115位精神分裂症患者在急性與慢性期的結構轉變，我們發現兩階段的症狀結構皆有負性類別，且大多數在急性期屬於負性類別的病患，在慢性期仍會保留在負性類別中，顯示負性症狀不易治癒的可能性。

The main aim of the study is to examine the structure of the PANSS items by using the regression extension of latent class analysis (RLCA) and focuses mainly on the changes in latent class of the PANSS over time. The RLCA identified five-class labeled as mixed, negative, disorganized thought, delusion and positive/a little mixed on 219 acute patients, and identified four-class labeled as a little mixed, negative, delusion and no-symptoms on 225 chronic patients. Based on the research, it was indicated that the symptom structure on the chronic schizophrenia was nested within the symptom structure on the acute schizophrenia. In addition, the latent transition analysis (LTA) was carried out to examine the changes of latent class on 115 patients who had assessed PANSS in both two phases. We found that the component of the negative class was stability over time and most patients who belonged to the negative class in the acute phase would still retain in the negative class in the chronic phase.