تغییرات پدیدارشناسانه در توهم شنوایی کلامی مزمن در اسکیزوفرنی

Presenting Author details:cjs0107@gmail.com San6, Eungam2-Dong, Eunpyeong-Gu, 122-913 Seoul, Republic of Korea, Tel.: +82 2 300 8286; fax: +82 2 300 8255. Background: Auditory verbal hallucinations (AVHs) are inherently subjective symptoms and occur in about 60% of patients diagnosed with schizophrenia. Difficulty in conducting clinical studies of AVHs may be partly attributable to heterogeneous population with regard to clinical status and course of illness. The aim of this longitudinal study was to find the changes in symptom structure of AVHs in schizophrenia by analyzing the data from patients with first episode or chronic schizophrenia and to evaluate the structural stability of AVHs. Methods: Forty DSM-IV schizophrenia patients (drug-naïve first episode schizophrenia, N = 21 and drug-free chronic schizophrenia, N = 19) experiencing AVHs were evaluated by the Psychotic Symptom Rating Scales – Auditory Hallucination Subscale (PSYRATS-AHS) twice at 6-month interval (before the initiation of antipsychotic treatment and after 6-month antipsychotic treatment). To understand dynamic changes in cluster structure of phenomenological variables of AVHs and to obtain useful graphical information on the changes in constituents and properties of clusters through 6-month antipsychotic treatment, hierarchical clustering (HC) and multidimensional analysis (MDS) were performed. Results: Phenomenological variables of AVHs formed the emotional and cognitive clusters from baseline through 6-month follow-up. Psychosocial disruption, which initially formed a cluster with cognitive variables, congregated with emotional variables at stable phase. In sub-group analysis, cluster structure of first episode group showed more dynamic changes at an interval of 6 months compared to chronic schizophrenia group. Phenomenological variables also formed two main clusters in both groups at stable phase. As for psychosocial disruption, a similar shift from cognitive to emotional cluster was observed in both groups. Conclusions: These results suggest that clinical significance of two main domains (emotional or cognitive characteristics) of AVHs may differ in accordance with clinical status. Acknowledgement: Grant # M103KV010012-06K2201-01210 from the Brain Research Center of the 21st Century Frontier Research Program funded by the Ministry of Science and Technology, Republic of Korea. Copyright © 2007 Published by Elsevier B.V.