A Study Of Loneliness And Empathy Defects In Long-term Hospitalized Schizophrenic Patients

Background: Empathy is the understanding of other persons’ feeling, mentalstate of others and the behavior of others. Empathy defect seriously affectsthe patient’s interpersonal and social functional ability. It has been proven thatthe empathy defect does exist in the schizophrenic patients, but there arecontroversial issue about the related factors. There have been few studies of theloneliness and related factors of schizophrenic patients until now. At the sametime little attention was paid to the loneliness of schizophrenic patients, not tosay the lack of specific clinical interventions. So the scientific, objective andeffective experimental design and measurement methods were needed for thestudy. Objective: To investigate the loneliness and empathy defectcharacteristics and related factors of long-term hospitalized schizophrenicpatients. By analyzing the results of the psychological measurement of theclinical symptoms, the empathy ability, feeling of loneliness and socialfunctional disability of the schizophrenic patients, so to explore the clinicalsymptoms and the characteristic of the empathy defect and loneliness of theschizophrenic patients. In order to concern the differences between the hospitaland non-hospital pattern in the clinical symptoms, empathy defect andloneliness, and to clarify the influence of the long-term hospitalization mode to the above symptoms. To provide the theoretical basis for the prognosis andimprovement of the cognitive deficits and the social function, at the same timeto provide a beneficial way for the management of the severe mental illness andreduce the burden of the disease. Methods: This is a case-control study. FromNovember2011to February201467hospitalized schizophrenicpatients(male:43, female:24) who were in line with International Classificationof Diseases10th edition (ICD-10) diagnostic criteria from the Lu Zhou MentalHealth Center of Sichuan Province were divided into the study group. While66non-hospitalized schizophrenic patients(male:37, female:29) from the samehospital were randomly selected as the control group. The general survey scale,positive and negative symptom scale score sheet (PANSS), interpersonalreactions pointer scal (IRI-C), emotional-social loneliness scalequestionnaire(ESLS), UCLA Loneliness Scale, social support revalued scale(SSRS) and Perceived social support scale (PSSS) were used to investigate theclinical symptoms, the empathy defect, the loneliness and social function inboth groups. Result:1. General data: there were67cases in the study group(male:43, female:24). The age were38.91±12.63years old and the educationalyear were9.22±3.21years. There were66cases in the control group (male:37,female:29). The age were36.53±13.72years old and the educational year were9.98±3.40years. There were no significant statistical differences between thetwo groups(P>0.05) in gender, age and education level.2.The comparison ofclinical symptoms between the two groups: the total PANSS scor（e37.70±8.16） of the study group were higher than those in the control group（31.41±4.78）andthe difference was statistically significant(t=-3.32,P<0.01). The score of thenegative symptom, cognition defects, depression and anxiety, positive symptomand excited hostility sub-scale in the study group were higher than those in thehospitalized patients were higher than those in the control group and thedifference was statistically significan（tP all＜0.01）.3.The feeling of lonelinesscomparison of the two groups: the total ESLS score（29.78±5.58）of the studygroup were higher than those in the control group（27.16±3.79）and thedifference was statistically significant(t=-3.17,P<0.01).4. The empathy defectscomparison of the two groups: the score of the interpersonal reaction pointer,social support and perceived social support of the study group were lower thanthose in the control group and the difference was statistically significant (P all＜0.05). The total score of the interpersonal reaction pointer of the study group（31.39±11.02）were lower than those in the control group（39.69±9.61）and thedifference was statistically significant (t=4.61,P<0.01)； the total score of thesympathy care subscale of the study group（9.21±3.46）were lower than those inthe control group（11.18±2.93）and the difference was statistically significant(t=3.55,P<0.01)； the total score of the social support of the study group（27.42±8.12）were lower than those in the control group（29.70±6.13）and thedifference was not statistically significant (t=1.82,P=0.07)； the total score ofthe perceived social support of the study group（45.85±15.15）were lower thanthose in the control group（61.18±13.67）and the difference was statistically significant (t=6.13,P<0.01)； the score of the family support, social supportand other support subscale of the study group were lower than those in thecontrol group and the difference was statistically significant (P all<0.01).5.①The empathy ability of the study group showed the negative correlation withthe emotion-social loneliness and the difference was statistically significant(r=-0.318,P<0.01), in which the total score of emotional loneliness factorshowed the negative correlation with that of perspective taking, imaginationfactor and interpersonal reactions pointer and the difference was statisticallysignificant (r=-0.315,P=0.01)、(r=-0.423,P<0.01)、(r=-0.350,P<0.01)respectively； the total score of emotions-loneliness showed the negativecorrelation with that of social perspective taking factor and imagine factor andthe difference was statistically significant (r=-0.484,P<0.01)、(r=-0.326,P<0.01)respectively.②T he loneliness of the study group showed thenegative correlation with social support and the difference was statisticallysignificant. The total score of emotional-social loneliness showed the negativecorrelation with that of social perspective takingfactor(r=-0.483,P<0.01),family support factors(r=-0.440,P<0.01), socialsupport factors(r=-0.425,P<0.01) and other supportingfactors(r=-0.425,P<0.01). The total score of social loneliness subscale showedthe negative correlation with that of family support factors(r=-0.498,P<0.01)，social support factors(r=-0.486,P<0.01) and other supportingfactors(r=-0.441,P<0.01) and social perspective taking factors(r=-0.530,P<0.01) of perspective taking scale. The total score of emotion-social lonelinesssubscale showed the negative correlation with that of objective social supportfactors(r=-0.393,P<0.05), subjective support factors (r=-0.497,P<0.01) andsupport utilization factor (r=-0.575,P<0.01). The total score of social lonelinessof emotion-social loneliness subscale showed the negative correlation with thatof objective social support factors(r=-0.424,P<0.01), subjective factors support(r=-0.585,P<0.01) and support utilization factor (r=-0.578,P<0.01) of socialsupport scale.③The empathy ability of the study group showed the positivecorrelation with social support and the difference was statistically significant.The total score of interpersonal reactions pointer showed the positivecorrelation with that of support comprehension(r=0.346,P<0.01)； the totalscore of perspective taking factors showed the positive correlation with that offamily support factors(r=0.748,P<0.01),social support factors(r=0.565,P<0.01),other supporting factors(r=0.50,P<0.01) and supportm comprehensionfactors(r=0.579,P<0.01)； the total score of sympathy factor showed thepositive correlation with that of social support factors (r=0.229,P<0.01), othersupporting factors(r=0.179,P<0.05) and support comprehension factors(r=0.194,P<0.05)； the total score of imagine factor showed the positivecorrelation with that of social support factors(r=0.185,P<0.05) and supportcomprehension factors(r=0.173,P<0.05)； the total score of interpersonalreactions pointer showed the positive correlation with that of family supportfactors(r=0.292,P<0.01), social support factors (r=0.350,P<0.01) and other supporting factors (r=0.287,P<0.01)； the total score of perspective takingfactors showed the positive correlation with that of subjective support factors（r=0.249,P<0.05）, objective social support factors（r=0.292,P<0.05）andsupport utilization factor（r=0.622,P<0.01）； the total score of imagine factorsshowed the positive correlation with that of objective factors (r=0.25,P<0.05).Conclusion:1.There were obvious clinic symptoms, empathy defect, lonelinessand social dysfunction in long-term hospitalized schizophrenic patients, whichshowed the different hospitalized and non-hospitalized pattern would lead tothe difference among the clinical symptoms, empathy defect, the loneliness andsocial support.2.The empathy ability of long-term hospitalized schizophrenicpatients showed the negative correlation with emotion-social loneliness. Theless the empathy ability the patients showed, the more the loneliness thepatients showed.3.The loneliness of long-term hospitalized schizophrenicpatients showed the negative correlation with social support.4.The empathyability of long-term hospitalized schizophrenic patients showed the positivecorrelation with social support. If the patients showed the worse empathyability and defect, then there was less social support.