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目的 探讨社区精神分裂症患者自知力状况,及其与人口学特征、临床特征和生活质量的关系.方法 对623例社区精神分裂症患者采用自制资料调查表、简明精神病量表、锥体外系副反应评定量表、蒙哥马利抑郁评定量表、医疗结局研究表格、自知力和治疗态度问卷进行测评分析. 结果 本组72.4%的患者自知力好,27.6%的患者自知力受损.不同自知力患者在首次发作、病程、住院次数、临床症状、药物应用、氯丙嗪当量等临床方面,以及发病年龄、受教育时间人口学资料方面比较差异有统计学意义(P0.05).回归分析显示,病程、阴性症状、不服药、苯二氮艹卓类药物使用率是自知力的独立影响因素(P<0.01).结论 社区精神分裂症患者自知力较好,自知力受病程、阴性症状等因素影响,与生活质量无关.“,”Objective To explore the insight status of community schizophrenics and its relationships to demographic characteristics, clinical features or quality of life.Methods Assessments were performed in 623 community schizophrenics using self-made information questionnaire, Brief Psychiatric Rating Scale (BPRS), Rating Scale for Extrapyramidal Side Effects (RSESE), Montgomery-Asberg Depression Rating Scale (MADRS), 12-Item Short Form Health Survey (SF-12) and Insight and Treatment Attitudes Questionnaire (ITAQ).Results 72.4% of the patients had good insight and 27.6% poor.There were significant differences in clinical aspects such as first-episode, course, hospitalization frequencies, used drugs and chlorpromazine equivalence as well as demographic data as onset ages and times of receiving an education among patients with different insights (P0.05).Regression analysis showed that independent influencing factors of insight were course, negative symptoms, refusing to taking drug and the utilization rate benzodiazepines (P<0.01).Conclusion Community schizophrenics have better insights, their insights are influenced by course and negative symptoms, and have nothing to do with quality of life.