综合干预对精神分裂症患者回归社区的效果观察  

Effect of synthetic intervention on schizophrenic outpatients re-entry community

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

机构地区：[1]山东省精神卫生中心防治科,济南250014

出　　处：《中华健康管理学杂志》2010年第6期362-365,共4页Chinese Journal of Health Management

基　　金：山东省医药卫生科技发展计划项目（2001CA1DFA1）

摘　　要：目的观察综合干预措施对精神分裂症患者出院后回归社区的疗效。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、半年未、1年末分别对两组患者采用精神分裂症社会支持量表（SSRS）、阳性与阴性症状量表（PANSS）进行评估和比较。结果人组时干预组与对照组的SSRS、PANSS评分差异无显著性意义（P〈0．05）；干预1年后，干预组SSRS总分（32．85±12．18）、客观支持分（9．15±4．18）、主观支持分（16．92±7．34）、对支持的利用度（6．77±2．09）均高于对照组（31．05±8．35、7．77±4．36、13．46±7．87、6．23±2．12），差异具有显著性意义（P〈0．05）。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），差异具有显著性意义（P〈0．01）。干预组复发率18．18％（26例）低于对照组34．75％（49例），差异有显著性意义（X^2=10．03，P〈0．01）。结论综合干预措施有利于出院的精神分裂症患者早日回归社区。Objective To investigate the effect of synthetic intervention on community re-entry of outpatients with schizophrenia. Methods Two hundred and eighty-four patients were randomly assigned to the intervention group （ n = 143 ） and the control group （ n = 141 ）. The participants in the intervention group received mental health education, medication consultation, skill training and family-based psychological intervention for I year. The control group was followed up through clinic visits. At baseline, half a year and the end of the year,all the subjects completed the Social Support Rating Scale （SSRS） and the Positive and Negative Syndrome Scale （ PANSS ） . Results The scores of SSRS and PANSS at baseline were not significantly different between the two groups. At the end of the year, the score of SSRS （32. 85 ± 12. 18 ） , the objective support subscale （9. 15 ±4. 18） ,the subjective support subseale （ 16. 92 ±7.34） and the support utility subscale （6. 77 ± 2.09 ） in the intervention group were significantly increased when compared with the control group （ 31.05 ± 8. 35,7.77± 4. 36,13.46 ± 7.87,6. 23 ± 2. 12, all P 〈 0. 05 ）. The score of PANSS （38. 88 ±9. 58 ）, the positive subscale （ 7. 40 ± 1.12 ）, the negative subscale （ 11.32 ± 5. 92） and the general psychopathology subscale （ 20. 16± 5.19 ） in the intervention group showed significant difference with the control group （46. 88± 16. 37,8.60 ± 3.19,13.52 ±7. 81,24. 76 ± 8.08, all P 〈 0. 01 ）. At the end of the year,the relapse of psychotic symptoms in the intervention and the control group was 18.18% and 34. 75%, respectively （ X^2 = 10. 03, P 〈 0. 01 ）. Conclusion The study results suggest that synthetic intervention could be effective for schizophrenic outpatients in community re-entry.

关 键 词：精神分裂症 干预性研究 社区卫生服务 

分 类 号：R749.3[医药卫生—神经病学与精神病学]