精神分裂症患者用药依从性及复发情况的调查  

Compliance with antipsychotic treatment and relapse in schizophrenia

作　　者：宓为峰[1] 邹连勇[1] 李梓萌[1] 程嘉[1] 耿彤[1] 杜波[2] 李建峰[2] 陈景旭[3] 韩瑞俊[3] 马文斌 熊健 史子千 李玲芝[1] 黄兰[1] 刘永桥[2] 张鸿燕[1] 

机构地区：[1]北京大学第六医院卫生部精神卫生学重点实验室（北京大学）,100191 [2]河北省第六人民医院临床药物试验机构办公室 [3]北京回龙观医院精神科 [4]辽宁省锦州市康宁医院精神科

出　　处：《中华精神科杂志》2012年第1期25-28,共4页Chinese Journal of Psychiatry

摘　　要：目的研究在自然非干预状态下影响精神分裂症患者服药依从性和复发率的因素，探讨精神分裂症患者出院后1年的服药依从性和复发情况。方法在全国4家精神卫生中心随机抽取规定时间跨度内（2009年1—8月）任意2个月各中心出院的精神分裂患者的整体作为研究对象，采用病历调查和电话采访的方式，对精神分裂症患者出院后1年的治疗情况进行回顾性问卷调查。主要观察指标为依从率和出院后1年复发率。结果共完成有效调查问卷537份，患者出院后1年服药依从率为57．9％，复发率为40．8％。服药依从者与不依从者复发率的差异有统计学意义，依从性与复发情况有关联（χ2=34．62，P〈0．01；OR=0．31，OR值95％可信区间为0．21～0．46）；经济水平与依从性有关联（χ2=12．43，P〈0．05；OR=2．59，OR值95％可信区间为1．51—4．42）；共同居住人情况与复发率有关联（χ2=12．37，P〈0．05；OR=0．31，OR值95％可信区间为0．11～0．91）。结论接受调查的精神分裂症患者出院1年后的用药依从性较高，复发率与国外研究相当；依从性、共同居住人情况可能影响复发率，经济水平可能影响依从性。Objective To explore the factors related to the compliance with antipsychotic treatment after 1 year of discharging from hospital and relapse rates among schizophrenia patients in nature status without interventions. Methods The study randomly selected schizophrenic inpatients who were discharged from hospital in arbitrarily 2 months from January 2009 to August 2009 in 4 mental health hospitals in China. The study got the schizophrenic patients＇ clinical therapy information after 1 year of discharging by telephone interview. The main detection indexes were compliance rate, relapse rate. Results The survey received 537 effective questionnaires, the compliance rate after 1 year of discharging was 57.9% , and the relapse rate was 40. 8%. The relapse rate was significantly different between patients with and without compliance （χ2 =34. 62, P 〈 0. 01, OR = 0. 31, 95% C1 of OR O. 21 to 0. 46）. The economic level was associated with the compliance rate （ χ2 = 12.43, P 〈 0. 05 ; OR = 2. 59, 95% CI of OR 1.51 to 4.42）. The caregiver situation was associated with the relapse rate （ χ2 = 12. 37, P 〈 0. 05 ; OR = 0. 31,95 % CI of OR was from 0.11 to 0.91 ）. Conclusions The compliance rate among the schizophrenia patients in this study is relatively high with similar relapse rate to the studies abroad. The compliance rate and the caregiver situation might be related to the relapse, and economic level might be related to the compliance.

关 键 词：精神分裂症 抗精神病药 病人依从 复发 

分 类 号：R749.3[医药卫生—神经病学与精神病学]