精神分裂症患者精神残疾相关因素分析  

Factors related to mental disability in patients with schizophrenia

作　　者：徐文炜[1] 张凤娟[1] 吴世珍[1] 吴晓梅[1] 费静霞[1] 朱培俊[1] 

机构地区：[1]南京医科大学附属无锡精神卫生中心精神科,江苏省无锡市214151

出　　处：《中国临床康复》2006年第18期35-37,共3页Chinese Journal of Clinical Rehabilitation

基　　金：无锡市社会发展基金项目(CS050004)~~

摘　　要：目的:评定精神分裂症患者的精神残疾现状,并探讨精神残疾相关因素。方法:于2005-09/2006-01采用分层随机抽取的原则,从无锡市黄巷、山北、清名桥和金星4个街道的1347例精神分裂症患者中,按照随机数字表法以5∶1比例随机抽取269人。其中43人拒绝访视或去外地生活,实际调查人数为226例。符合中国精神障碍分类与诊断标准第3版的精神分裂症诊断标准。对精神分裂症患者进行社会功能缺陷筛选量表结合日常生活能力量表和功能大体评定量表综合判断。根据调查内容收集与残疾有关的危险因素。调查内容有患者人文资料、精神症状、精神残疾相关因素、生活质量评定及社会功能缺陷评定等5个方面。采用二项Logistic回归对精神残疾的影响因素进行分析。结果:226例精神分裂症患者进入结果分析。①精神残疾评定情况:无精神残疾16.81%,轻度精神残疾38.94%,中度精神残疾25.22%,重度以上19.03%。其中男性残疾患者69.2%,女性残疾患者69.2%,男女两组残疾率差异无显著性意义(χ2=0.264,P=0.608)。②残疾和非残疾组之间有显著性差异的变量有:病前及病后婚姻状况,居住状况、家庭关心程度、有无躯体疾病、药物治疗种类、疾病亚型、医院干预模式、家庭人均可分配收入、起病年龄、受教育程度、阴性症状以及生存质量等12个因素。③受教育程度、月人均可支配收入和生活质量-社会关系满意度与精神残疾程度呈负相关,阳性和阴性症状量表中的阴性症状分、一般精神病理量表、居住情况、家属关心程度及有无躯体疾病与精神残疾的程度呈正相关,对回归方程模型的适配度作方差检验显示有显著性意义(χ2=24.630,df=8,P=0.002)。结论:调查结果显示自身精神症状严重、又伴有躯体疾病的精神分裂症患者,生活在社会关系差、经济收入低、居住条件差以及家属较少关心的环境中AIM： To evaluate the mental disability and the related risk factors in schizophrenic patients. METHODS： According to the principle of stratified sampling, 269 cases were selected from 1 347 schizophrenic patients of four streets of Huangxiang, Shanbei, Qingmingqiao and Jinxing in Wuxi city by the method of random number table between September 2005 and January 2006, 43 of them refused the interview of to live in other places, and 226 cases were investigated actually, and they all accorded the diagnostic standard for schizophrenia in the third edition of the Chinese Classification and diagnostic criteria of Mental Disorders （CCMD-3）. All the schizophrenic patients were assessed with social disability screening schedule （SDSS）, the Chinese version of activity of daily living scale （ADL） and global assessment function （GAF）. The factors related to the mental disability were selected. The contents of investigation included five aspects of the humanistic data, psychiatric symptoms, factors related to mental disability, ADL and SDSS. A binary Logistic regression model was used to analyze the risk factors for mental disability in schizophrenia. RESULTS： Totally 226 patients with schizophrenia were involved in the .analysis of results. ① Evaluation of mental disability： Of the 226 patients with schizophrenia, 16.81% had no mental disability, 38.94%, 25.22% and19.03% had mild, moderate and severe mental disability respectively, 69.2% of the males and 69.2% of the females had the mental disability, and there was no significant difference between males and females （X^2 =0.264, P=0.608）. ② The variances which were significantly different between the disable group and without disability group included 12 factors of status of marriage before and after disease, dwelling condition, degree of care from family, with or without physical disease, kinds of drug therapy, subtype of disease, pattern of intervention from hospital, family distributable income for each person, attack age, educational back

关 键 词：精神分裂症 精神残疾人 因素分析 统计学 

分 类 号：R749.3[医药卫生—神经病学与精神病学]