儿童精神分裂症预后调查及综合干预研究  

Study of prognosis investigation and comprehensive intervention to the children with schizophrenia

作　　者：刘寰忠[1] 郜见亮[1] 潘多[1] 沈怡芳[1] 王克永[1] 

机构地区：[1]安徽省精神卫生防治中心精神科,合肥230022

出　　处：《安徽医科大学学报》2014年第3期385-388,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省卫生厅临床医学重点学科应用技术资助项目(编号:09B130)

摘　　要：目的回顾性调查儿童精神分裂症预后影响因素并进行前瞻性综合干预研究,探讨改善儿童精神分裂症患者预后的方法。方法首先回顾性调查安徽省精神卫生中心儿童青少年心理科符合中国精神疾病分类方案与诊断标准第3版关于儿童精神分裂症诊断标准的166例患者（调查组）。另选126例出院的儿童精神分裂症患者（干预组）进行前瞻性综合干预研究。两年后进行预后评估,采用临床总体印象量表（ CGI）、个人和社会功能量表（ PSP）作为预后结局标准。综合干预方案：[1]知情同意；[2]每月定期随访；[3]通过电话、网络等平台建立沟通渠道,出现问题及时联系及时解决；[4]服药依从性干预包括科普知识普及和健康宣教；[5]家庭干预；[6]心理干预。结果[1]调查组 PSP 评分11~93（65.6±23.9）分。以PSP得分为因变量经多元逐步回归分析,有明确影响的是出院疗效、居住地、自知力和是否独生子女。于干预组有89例完成两年随访。两年后完成横断面评估121例,其中CGI评分情况如下：1分51例,2分20例,3分8例,4分以上共42例。 PSP评分5~99（76.7±28.4）分。[3]经字2检验和独立样本t检验,调查组与干预组在性别、年龄、住院天数、出院疗效上差异无统计学意义。榆干预组两年后PSP评分为（76.7±28.4）分,明显高于干预前和调查组（P〈0.05）。结论经综合干预,儿童精神分裂症预后显著改善；总体预后高于前期调查组。Objective To investigate the prognosis and explore the effects of the comprehensive intervention of the children with schizophrenia. Methods First, retrospective investigation of 166 children schizophrenia patients（ in-vestigation group） according to the standard of CCMD-3 who accepted inpatient treatment in the department of child and adolescent psychology in Anhui Mental Health Center. Another 126 outpatients of children schizophrenia （ in-tervention group） accepted prospective comprehensive intervention. The clinical global impression scale, personal and social functioning scale were used as prognostic outcome criteria to evaluate the prognosis after two years. Com-prehensive intervention programs were as follows： ① Informed consent; ② Regular monthly follow-up; ③ Set up channels of communication by telephone or internet to resolve problems timely;④ Medication adherence interven-tions including popular science knowledge and health education;⑤Family intervention;⑥Psychological interven-tion. Results ① The score of PSP in investigation group was 11 ~93（65.6 ±23.9）. The clear factors on PSP score tested by multiple stepwise regression analysis were the therapeutic effects, residence, insight, and family one-child. ②89 cases of intervention group completed two years follow-up. 121 cases were accepted in cross-sec-tional assessment after 2 years, and the CGI score was as follows：51 cases got 1 point, 20 cases got 2 points, 8 ca-ses got 3 points and 42 cases got 4 points or more. The score of PSP was 5~99（76.7±28.4）. ③By chi-square and independent samplet test, there was no significant difference in gender, age, length of hospital stay and thera-peutic effect out hospital between investigation and intervention groups.④The PSP score of intervention group after two years was 5~99（76.7±28.4）, which was significantly higher than that of pre-intervention and investigation group （ P〈0.05 ） . Conclusion The overall prognosis of the children with schizophrenia significant

关 键 词：精神分裂症 儿童 预后 干预 

分 类 号：R749.94[医药卫生—神经病学与精神病学]