社区综合干预对精神分裂症患者社会康复效果的对照研究  

Comparative study of effects of comprehensive intervention in community on schizophrenic social rehabilitation

作　　者：王延祜[1] 唐济生[1] 柴新生[1] 郑崇泉[1] 张敬悬[1] 翁正[1] 

机构地区：[1]山东省精神卫生中心,济南250014

出　　处：《精神医学杂志》2009年第4期244-246,共3页Journal of Psychiatry

基　　金：山东省医药卫生科技发展计划项目(课题编号:2001CA1DFA1)

摘　　要：目的观察社区综合干预措施对精神分裂症患者出院后社会康复的疗效。方法采取随机抽样法,将284例出院的精神分裂症患者随机分为干预组(143例)和对照组(141例),对干预组进行健康教育、用药指导、技能训练、家庭治疗等综合干预,持续1年;对照组仅进行门诊随访。在入组时、半年末、一年末分别对两组患者采用社会功能缺陷筛选量表(SDSS)、阳性与阴性症状量表(PANSS)进行评估和比较。结果入组时干预组与对照组的SDSS、PANSS评分差异无显著性;干预1年后,干预组SDSS评分(7.54±2.11)明显低于对照组(9.77±2.74),差异具有非常显著性(P<0.01)。干预组PANSS评分(38.88±9.58)、阳性量表评分(7.40±1.12)、阴性量表评分(11.32±5.92),一般精神病理量表评分(20.16±5.19)均低于对照组(46.88±16.37、8.60±3.19、13.52±7.81、24.76±8.08),差异具有非常显著性(P<0.01)。干预组复发率18.18%(26例)低于对照组34.75%(49例),差异有非常显著性(2=10.03,P<0.01)。结论综合干预措施有利于出院后精神分裂症患者的社会康复。Objective To investigate the effect of comprehensive intervention in community on schlzophrenic social rehabilitation. Methods A total of 284 patients with schizophrenia were randomly divided into intervention group （n= 143） and control group （n= 141）. The cases in intervention group were regularly provided mental health education, close advice, skills training and family psychological intervention by psychiatrists for 1 year, while the cases in control group were only followed by clinic visits. All cases were assessed at baseline, half a year and end of the year by instruments including Social Disability Screening Schedule （SDSS）, Positive And Negative Symptom Scale （PANSS）. Results The scores of SDSS and PANSS had no significant differences between two groups at baseline. At the end of the year, the score of SDSS （7.54±2.11） in intervention group was significantly lower than that in control group （9.77±2.74, P〈0.01）. The total score of PANSS （38. 884±9.58）, the scores of positive subscale （7. 404-1.12）, negative subscale （11. 324±5.92） and the general psychopathology subscale （20.16 4±5. 19） in intervention group were also significantly lower than those in control group （46. 884±16.37, 8. 604±3.19, 13. 524±7.81, 24. 764±8.08, P〈0.01）. The relapse rates in intervention and control groups were 18.18% and 34.75% （χ^2 =10.03,P〈0.01） at end of the year and significant difference was found. Conclusion The comprehensive intervention is effective for social rehabilitation in schizophrenia.

关 键 词：精神分裂症 综合干预 社区 

分 类 号：R749.3[医药卫生—神经病学与精神病学]