精神分裂症院内康复措施及其疗效的一年随访  

Efficacy of the rehabilitative strategy for inpatients with schizophrenia: one year follow-up study

作　　者：翁永振[1] 向应强[1] 陈学诗[1] 侯也之[1] 封砚村[1] 

机构地区：[1]首都医科大学附属北京安定医院,100088

出　　处：《中华精神科杂志》2002年第1期32-35,共4页Chinese Journal of Psychiatry

基　　金：北京重点扶持学科基金资助项目 [( 1999)卫科扶字 10号 ] ;首都医学发展科研基金资助项目(ZD199816 )

摘　　要：目的　探讨院内康复措施对精神分裂症患者的作用。方法　将 12 4例精神分裂症住院患者随机分为措施干预组和对照组 ,每组各 6 2例。在抗精神病药治疗的同时 ,对干预组施以小组工作制、院内职业康复的两种技能训练 ,共 10周。出院后随访 1年。用简明精神病评定量表 (BPRS)、住院病人护士观察量表 (NOSIE 30 )、社会功能缺陷筛选量表 (SDSS)和就业率等进行评估。结果　 (1)与入组时比较 ,住院期间干预组NOSIE 30各因素的变化值从住院的第 2周开始至第 10周均优于对照组(均P <0 0 1) ,且增分和减分的幅度逐渐增大。 (2 )出院时点与随访最后时点评分差值的比较 ,干预组的SDSS分 [(4 0± 2 7)分 ]、NOSIE 30积极因素分 [(- 2 4 8± 4 9)分 ]和消极因素分 [(8 9± 3 6 )分 ]均显著优于对照组 [分别为 (- 3 9± 1 9)分、(5 2± 5 0 )分和 (- 19 5± 5 9)分 ;均P <0 0 1～P <0 0 0 1];(3)干预组的复发率 (10 %)、再住院率 (3%)和再就业率 (4 1%)皆优于对照组 (分别为 6 9%、5 6 %和 13%,P =0 0 0 0 )。结论　院内康复措施对控制精神分裂症患者的病情、提高社会功能和再就业率 ,以及降低复发率和再住院率具有重要的作用。Objective To explore efficacy of the rehabilitative strategy in hospitalized schizophrenics. Methods One hundred and twenty-four schizophrenic inpatients were randomly divided into the strategy intervention group and control group. Both groups received the antipsychotics treatment, but the teamwork education, occupational therapy, and two kinds of skills training were only given to the strategy intervention group. And a one-year follow-up was carried out after their discharge from hospital. All subjects were evaluated with the Brief Psychiatic Rating Scale(BPRS), Nurses′ Observation Scale for Inpatient Evaluation-30(NOSIE-30), Social Disability Screening Schedule(SDSS), and relapse rate, reemployment rate, re-hospitalization rate. Results The clinical outcome in strategy intervention group demonstrated significantly superior to the control group on overall improvement according to the relapse rate (10% vs. 69%), re-hospitalization rate (3% vs. 56%), re-employment rate (41% vs. 13%), reduction of SDSS score (4.0±2.7 vs. -3.9±1.9), increase of active factor score of NOSIE-30 (-24.8±4.9 vs. 5.2±5.0), and the reduction of inactive factor score of NOSIE-30 (8.9±3.6 vs. -19.5±5.9, P<0.01-P<0.001). Conclusions The effect of rehabilitative strategy for hospitalized schizophrenia patients not only reduce their social disabilities and increase the reemployment rate, but reduce relapse and re-hospitalization.

关 键 词：精神分裂症 康复 治疗 随访研究 出院 

分 类 号：R749.3[医药卫生—神经病学与精神病学]