综合干预联合网络咨询对社区精神分裂症患者预后影响的1年随访  

A comprehensive intervention with online consultation for outpatients with schizophrenia for one year

作　　者：肖春玲[1] 韩笑乐[1] 张喜梅[1] 陈彦方[1] 邹义壮[1] 郭蓄芳[1] 刘丹[1] 姚长莉[1] 袁秀霞[1] 张桂花[2] 

机构地区：[1]北京回龙观医院,北京心理危机研究与干预中心,世界卫生组织自杀预防研究与培训合作中心,100096 [2]北京民康医院

出　　处：《临床精神医学杂志》2013年第2期73-75,共3页Journal of Clinical Psychiatry

基　　金：美国中华医学基金会(Small Grants Program #02-777)

摘　　要：目的:探讨社区精神分裂症患者综合干预中联用网络咨询1年的效果。方法:对门诊精神分裂症患者106例进行可变剂量抗精神病药治疗12个月,分为实地随访干预结合网络咨询(试验组)25例和实地随访干预(对照组)81例。入组时以阳性与阴性症状量表(PANSS)、社会功能量表较基线的差值作为主要疗效指标;以网络咨询相关问题调查网络咨询的可接受性。结果:PANSS量表分随治疗下降,1个月后评分下降(P<0.01),保持降低趋势至12个月,治疗前组间差异无统计学意义。试验组社会功能损害渐改善(P<0.05),对照组改善不明显,12个月组间差异有统计学意义(P<0.05)。进行网络咨询相关问题调查表调查,试验组(72.0%)用网络解决医学问题者明显多于对照组(40.0%),差异有统计学意义(χ2=6.89,P<0.01)。多数患者(>70.0%)看好网络咨询前景等,但超过60.0%认为收费对其有影响,建议的网络咨询价格明显低于面对面咨询(P<0.001)。结论:社区精神分裂症综合干预中联用网络咨询有利于减轻症状和改善社会功能,网络咨询有利于方便服务,患者愿接受网络咨询。Objective： To explore the efficacy of comprehensive intervention with online consultation for outpatients with schizophrenia for one year. Method：A controlled follow-up study were adopted to 106 outpatients with schizophrenia.The patients were treated with antipsychotics combination of psychological therapy with online consultation （25 patients in trial group） or without online consultation （81 patients in controll group） for 12 months.The positive and negative syndrome scale （PANSS）,social functioning rating scale（SFRS）,the questionnaire with respect to acceptance of online consultation（IT）were used. Results：The PANSS scores decreased significantly （P0.01）at the end of 1 months,and continuously decreased at the end of 12 months.There was no significant difference between the two groups.For the trial group social functioning were improved at the end of 3 months（P0.05）,and continuously improved at the end of 12 months（P0.01）.For the controlled group,social functioning were not improved significantly.There was significant difference between the two groups at the end of 12 months（P0.05）.72.0% vs 40.0% of patients in two groups（χ2=6.89,P0.01） admired that online consultation could be easily accepted as that of treatment with medication.Over 70.0% of patients admired that online consultation could be easily accepted and over 60.0% of patients believed the cost would affect their economic condition. Conclusion：Comprehensive intervention with/without online consultation will provided with the convenient service for the outpatients with schizophrenia.The patients admired that online consultation could be easily accepted.

关 键 词：精神分裂症 综合干预 网络咨询 社会功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]