慢性精神分裂症患者社区康复与住院治疗效果评价  

Evaluations of community rehabilitation and hospitalization effectiveness in chronic schizophrenics

作　　者：曾会群[1] 李磊[1] 何淑芬[1] 

机构地区：[1]自贡市精神卫生中心,四川自贡643020

出　　处：《临床心身疾病杂志》2009年第4期311-313,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的评价社区康复与住院治疗慢性精神分裂症患者的临床效果。方法将168例慢性精神分裂症患者分为两组，每组84例，研究组实行封闭式管理的住院治疗，对照组实行开放式管理的社区康复治疗，观察3mo，随访6mo。于治疗前后及随访6mo末采用简明精神病量表评定临床疗效，社会功能缺陷筛查量表评定社会功能缺陷状况；于随访6mo末测评两组患者复发率和成本与费用。结果治疗后两组简明精神病量表总分均较治疗前有显著下降（P〈0．01）；同期两组间比较均无显著性差异（P〉0．05）。随访6mo末两组有效率比较无显著性差异（P〉0．05）。治疗后研究组社会功能缺陷筛查量表评分与治疗前无显著变化（P〉0．05）；对照组较治疗前有显著下降，且显著低于研究组（P〈0．01）。研究组复发率显著高于对照组（P〈0．01），且总体成本是对照组的3．02倍。结论社区康复治疗慢性精神分裂症患者的总体疗效与住院治疗相当，但在改善患者社会功能、降低复发率、减轻经济负担等方面均优于住院治疗。Objeceive To evaluate the effects of community rehabilitation and hospitalization in chrinic schizophrenics. Methods 168 chronic schizophrenics were divided into two groups of 84 patients each,research group received hospitalization of closed management and control did open community rehabilitative treatment ,they were observed for 3 months and followed up for 6 months. Efficacies were assessed with the Brief Psychiatric Rating Scale（BPRS） and social disability with the Social Disability Screening Schedule （SDSS） before treatment and after 6 month follow-up; relapse rates,cost and expense were assessed after 6 month follow-up for the patients of both groups. Results After treatment, the BPRS total scores of both groups lowered more significantly compared with pretreatment（P〈0. 01） ;there were no significant differences in synchronization intergroup comparisons（P〉0.05）. At the end of 6 month follow-up,there was no significant difference in effective rate between the 2 groups（P〉0.05）. There was no significant difference in SDSS scores between pre-and post-treatment in the research group（P〉0.05） ; the SDSS score was sig nificantly lower in the control group after treatment compared with pretreatment and than in the research group（P〈0.01）. The relase rate was significantly higher in the research than in the control group（P 〈0.01）, total cost of the research was 3.02 times that of the control group. Conclusion The total efficacy of community rehabilitation-treated chronic schizophrenics is equivalent to hospitalization, but has an ad vantage in improving social function,lowering relapse rate and lessening eeonimic burden etc. over hospitalization.

关 键 词：慢性精神分裂症 社区康复 住院 社会功能 复发率 经济负担 简明精神病量表 社会功能缺陷筛查量表 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R743.3[医药卫生—临床医学]