精神刺激物質依賴與精神病患兩組之照顧者住院時的表露情緒初探

A Pilot Study of Expressed Emotion between the Caregivers of Substance Dependence and Psychiatric Patients after Admission

目的：本研究以1996年7月至1997年2月A醫院80名精神刺激物質依賴病患的照顧者，及1994年8月至1995年1月B醫院118名精神病患的照顧者為對象，比較兩組照顧者表露情緒(Expressed Emotion; EE)之差異。方法：研究工具以「中國人五 分鐘演說樣本評估手冊(Chinese Five Minutes Speech Sample; CFMSS)」評估照顧者的EE。結果：1.物質依賴組照顧者的HEE多於精神病患照顧者，且與情緒過度介入、拒絕病患、父親角色有顯著關係。2.將社會人口因素及臨床因素與EE之間的關係檢定結果發現：兩組的照顧者一致出現教育程度偏低者傾向HEE；物質依賴組的臨床因素如病患用藥種類、首次用藥年齡、及用藥年數與EE有關，精神病患組的臨床因素關係不顯著，反而人口社會因素如照顧者的角色、性別、有無就業等因素與EE有關，此項發現顯示不同的疾病，家庭照顧者所出現的EE動力不同。3.CFMSS在不同樣本的應用都有其相當的信度和適用性。結論：本研究建議加強照顧者的社會心理教育。

Objective : The purpose of this study was to compare the caregivers' Expressed Emotion (EE) between substance dependence and psychiatric patients. Methods: It included the caregivers of 80-substance dependence and 118 of psychiatric patients. EE subgroup scores were obtained using the Chinese Five Minutes Speech Sample (CFMSS ) after admission. Results: 1. Comparatively, there were more high-EE was classified in the sample of substance dependence (66%) than psychiatric patients (41%). The HEE related factors in substance dependence group were emotional over-involvement, patient rejection attitude, and the social role of father. 2. Lower education was found to be significantly related to HEE to both groups. Regarding to the relation between clinical factors and EE, it was significant in substance dependence group, such as classification of drug using, age of onset, and duration of drug using, but not in psychiatric group. Instead, the most significant factors related to HEE in psychiatric groups were caregivers' gender, social role and work situation. 3. It was strongly recommended that the CFMSS significantly consistence in reliability through out of four studies with different samples. Conclusion: The results of this study suggested to enhance caregivers' psychosocial education. (Full Text in Chinese)