重性精神疾病关锁患者解锁救治后社会功能的改善  

Social function improvement in locked patients with psychoses after unlocking and treatment

作　　者：吴霞民[1,2] 刘津[2] 马宁[2] 管丽丽[2] 马弘[2] 于欣[2] 王燕[1] 

机构地区：[1]北京大学公共卫生学院,北京100191 [2]北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《中国心理卫生杂志》2013年第2期81-86,共6页Chinese Mental Health Journal

摘　　要：目的:探讨解锁救治对重性精神疾病关锁患者社会功能的改善情况,为制订关锁患者的救助政策提供参考。方法:使用自编调查问卷,在中央补助地方重性精神疾病管理治疗项目(简称"686"项目)区免费解锁救治的患者中,对符合研究标准的266例患者进行调查,分析解锁救治前后患者社会功能的变化。结果:解锁救治后,患者社会功能明显改善,其中变化最大的是个人生活料理能力和家务劳动能力。生活料理能力差的患者比例从解锁治疗前的97.0%下降到7.5%,家务劳动能力差的患者比例从97.8%下降到18.8%。患者被关锁时间越长,社会功能改善越差(β=0.07～0.14)。结论:解锁救治明显改善了患者的社会功能,提高了患者的生活质量。建议各级政府部门应借鉴686服务模式,不断加大和健全精神疾病社区防治康复网络建设,由点到面逐渐展开解锁救治工作。Objective： To explore the change of social function in patients with psychoses after unlocking and treatment, to provide information and references for making policy to aid locked patients. Methods： Totally 266 pa- tients involved in ＂National Continuing Management and Intervention Program for Psychoses＂ （named as ＂686＂ Program） who met the study criteria and were assessed with the self-made questionnaire and unlocked for free. The change of their social function before and after unlocking and treatment were estimated. The inclusion criteria were, 1） diagnosed as schizophrenia, schizoaffective, bipolar disorder, paranoid psychosis, mental retardation, mental dis- order caused by epilepsy according to the Chinese Classification and Diagnostic Criteria for Mental Disorders, Third Edition （CCMD-3）;2） diagnoses were made by two psychiatrists; 3） outpatients; 4） having the inform consent of patient himself/herself or his/her custodian. Results： After unlocking and treatment, the social function of patients improved remarkably. One of the biggest changes was individual living capacity and housework ability. The rate of patients of worse individual living capacity declined from 97.0% to 7. 5%, and the rate of patients with worse housework ability declined from 97.8% to 18.8%. The longer the patients were locked, the less the improvement of social function were. Conclusion： It suggests that unlocking and treatment could significantly improve patients＂ social function and life quality. Therefore, all levels of government are recommended to use 686 Service pattern for better construction of mental health primary care network, and should take the experience and popularize unlocking and treatment work step by step to the whole country gradually.

关 键 词：重性精神疾病 关锁 解锁救治 社会功能 横断面研究 

分 类 号：R749-012[医药卫生—神经病学与精神病学]