The Change Of Mentalization And Its Relationship With Symptoms And Social Function In Patients With First Episode Schizophrenia

Objective: Schizophrenia is by far the most prevalent and the most serious one of all mental disorders.Often accompanied by positive symptoms,negative symptoms and general psychopathology symptoms.There are defects in many aspects such as perception,thinking,emotion and behavior,which have a serious impact on the patients,families and society as well as a heavy burden.Social dysfunction is an important feature of schizophrenia,including the inability of individuals cannot reach the roles defined by society and and their satisfaction with their ability to take care of their own leisure and leisure activities is less than social function's general level.Most studies have found that patients with schizophrenia have a defect in their mentalization,including have difficulty in understanding the mental state of themselves and others and taking effective measures to deal with the problem.The aim of this study was to assess the relationship between psychiatric symptoms and social function by assessing the changes in the mental ability of patients with first-episode schizophrenia during acute treatment.It has significant importance to help understand the underlying neural mechanisms of schizophrenia and its development based on psychology clinical intervention.Methods:A total of 41 FEP eligible for DSM-V on the diagnosis of schizophrenia were enrolled.All patients were treated for atypical antipsychotics for a total of 8 weeks.All subjects enrolled were asked to fill in the general condition questionare.Positive and negative symptom scales(PANSS),personal and social function scales(PSP),and metacognitive assessment scale 2009 Chinese version(MAS-R2009)were used to assess the symptoms,social function and mentalization at baseline and on the 8th week of treatment,respectively.All data were processed by SPSS17.0 software.The changes of symptoms,social functions and mentalization scores before and after treatment were compared by paired sample t-test.The correlation between mentalization and symptoms and social function at baseline and at the end of the 8th week of treatment was analyzed Pearson correlation analysis and it was used to analyze the correlation between the change of mentalization and the improvement of symptoms and social function before and after treatment.The PANSS reduction rate of?50 was effective.We devided all the subjects into two groups according to the reduction rate of the PANSS.The score more than 50 is the effective group and the other is uneffective group.An independent sample t-test was used to compare the level of mentalization between the two groups at baseline and at the end of the 8th week of treatment.Results: 1.Before and after treatment,there were significant differences in the total scores and each sub-scores of PANSS,PSP scores,MAS-R2009 total scores and scores of sub-scales(P <0.01).2.At the baseline,metalization in the sub-scales in understanding of the self(r=0.425,P<0.01),the mastery(r=0.547,P<0.01),and the total score of MAS(r=0.490,P<0.01)had significant positive correlation with the total score of PSP,which was of statistical significance.At the baseline,the MAS scores were significantly negatively correalated with the PANSS total score and each subscales' s score(r=-0.355~-0.712,P<0.05).At the end of the 8th of the treatment,metalization in the sub-scales in understanding of the self(r=0.681,P<0.01),the mastery(r=0.546,P<0.01),and the total score of MAS(r=0.631,P<0.01)had significant positive correlation with the total score of PSP,which was of statistical significance.And the MAS scores were significantly negatively correalated with the PANSS total score and each subs-cales' s score(r=0.361~0.599,P<0.05).3.The score difference of mentalization before and after treatment were positively correlated with the score difference between PSP(t = 0.496,P <0.01)and that in MAS score(r=0.412,P<0.01),the correlation was statistically significant.Before and after the treatment of the first episode of schizophrenia,there was a positive correlation between the score difference in understanding of self and MAS total score,PANSS total score difference,positive symptom difference and general psychopathological difference(r = 0.361-0.599,P <0.05),the correlation was statistically significant.4.The PANSS score of ?50 group(markedly effective group)at baseline and the 8th week of treatment the understanding of self score,mastery score and MAS total score were higher than the PANSS score Rate <50 of the group(non-effective group),the difference was statistically significant(P <0.05).Conclusion: 1.Atypical antipsychotics have improved pychotic symptoms and social function and mentalization of FEP.2.No matter before or after the treatment of the first-episode schizophrenia patients,mentalization capacity and social function are positively correlated,mentalization capacity and symptoms are negatively correlated.3.After treatment,the mentalization ability improvement of patients with first episode schizophrenia is positively correlated with the improvement of social function and improvement of mental symptoms.4.After 8 weeks of medication in FEP,Compared with those who did not show markedly effective,their level of mentalization ability before treatment is higher,and at the same time,the level of their mentalization ability after treatment is also higher.