综合医院建立开放式心理病房治疗神经症及精神病患者的可行性(英文)  

Feasibility of establishing open psychology ward in general hospitals for patients with neurosis and mental diseases

作　　者：邹晓波[1] 林举达[1] 杨志江[1] 林志雄[1] 陈光敏[1] 

机构地区：[1]广东医学院附属医院心理科,广东省湛江市524001

出　　处：《中国临床康复》2005年第20期238-240,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:目前国内大多数综合医院对神经症及精神病患者治疗都是采取单纯门诊心理咨询方式,这一方式的应对已难于满足社会的精神障碍服务需求,成立开放式心理病房是否可行?目的:探讨建立综合医院开放式心理病房治疗神经症及精神病患者的新型管理模式的可行性。设计:以患者为观察对象,病例分析。单位:广东医学院附属医院心理科。对象:选择2000-07/2003-07在广东医学院附属医院心理病房住院的各类神经症患者688例,精神病患者112例,其中男523例,女377例,年龄11～80岁,平均年龄(42±8)岁,平均住院(17.0±6.5) d。方法:实行开放式管理模式,包括病房敞开式,建立支持系统,人性化约束,集体健身,精神支持等方法。由经过培训过的精神科医生采用症状自评量表对经过2个月康复指导的各类神经症及精神病患者900例进行疗效评定。对其中169例抑郁症患者在治疗2,4,8周时进行汉密顿抑郁量表测试。主要观察指标:①169例抑郁症患者治疗前后汉密顿抑郁量表评定结果。②900例患者疗效评定结果。结果:综合医院开放式心理病房管理模式具有患者生活自由、可保持与外界社会的接触好等特点,900例各类神经症及精神病患者基本恢复正常531例(59.0%)、显著好转264例(29.4%)、好转81例(9.0%)、无效24例(2.6%),总有效率97.4%,无一例发生意外。169例抑郁症患者治疗前汉密顿抑郁量表评分为32.3±3.6;住院治疗2周时为17.4±4.2;治疗4周时为11.5±4.8;治疗8周时为5.8±3.6;治疗2,4,8周时均明显低于治疗前,差异有非常显著性意义(P <0.01)。结论:综合医院开放式心理病房治疗的900例各类神经症及精神病患者的治疗有效率97.4%,并无意外发生,169例抑郁症患者治疗后的抑郁症状均较治疗前明显改善,说明综合医院建立开放式管理的心理病房具有可行性。BACKGROUND：At present,most general hospitals in China treat patients with neurosis and mental diseases merely hy means of clinical psychological consuhation,which cannot meet the requirements of social service for metal disorders.Is it feasible to establish open psychology wards？OBJECTIVE：To investigate the feasibility of establishing open psychology ward in general hospitals for patients with neurosis and mental diseases.DESIGN：Case analysis based on patients.SETTING：Department of Psychology of Guangdong Medical College Affiliated Hospital.PARTICIPANTS：Totally 900 patients with various types of neurosis were admitted to the Department of Psychology of Guangdong Medical College Affiliated Hospital between July 2000 and March 2003.There were 688 patients with different kinds of psychoneurosis and 112 cases of mental diseases.Of them,there were 523 men and 377 women aged from 11 to 80 years with the mean age of （42±8） years and hospitalization duration of（17.0±6.5） days.METHODS：Open management consisting of open ward,supporting system,humanized restriction,collective physical exercise and psychological support was adopted.Symptom checklist （SCL-90） was used by trained psychological doctors to assess the therapeutic effects in the 900 patients with neurosis and mental diseases after two-month rehabilitation.Meanwhile,169 patients with depression were examined with Hamilton rating scale for depression（HAMD） at 2,4,8 weeks of treatment.MAIN OUTCOME MEASURES：①The results of HAMD in the 169 depressive patients after treatment： ②The therapeutic effect in the 900 patients.RESULTS：Open psychology ward could provide an environment for patients to live and make free contact with the outside world.Of the 900 patients with various neurosis and metal diseases,531 （59.0%） had recovery to normal,264（29.4%） had obvious improvement,81（9.0%） had improvement,and 24 （2.6%） had no therapeutic effect,with the total effective rate of 97.4%.None of the patients had any accident.HAM

关 键 词：精神病 医院 综合 住院 心理疗法 

分 类 号：R749.055[医药卫生—神经病学与精神病学]