3种干预方法对社区慢性精神分裂症患者症状及其家庭负担影响的比较  

The effects of three interventions:cognitive behavioral therapy,family intervention and vocational rehabilitation intervention on outpatients and their family burden with chronic schizophrenia

作　　者：舒京平[1] 李洪建[1] 黄承保[1] 孙菡[1] 朱颖之[1] 汪四美[1] 蒋嘉慧 

机构地区：[1]江苏省常州市德安医院心理科,213003 [2]常州市北郊中学

出　　处：《临床精神医学杂志》2015年第6期403-405,共3页Journal of Clinical Psychiatry

基　　金：江苏省常州市科技计划项目(CS20102013)

摘　　要：目的：探讨认知行为治疗、家庭治疗、职业康复3种干预方法对慢性精神分裂症患者及其家庭负担的影响。方法：将慢性精神分裂症患者随机分为干预组（包括认知行为治疗组48例、家庭治疗组46例、职业康复组40例）及对照组44例,在维持原药物治疗基础上进行相应的干预治疗,历时1年。入组时和干预结束采用阳性与阴性症状量表（PANSS）和家庭负担会谈量表（FBS）对患者及家属进行评估。结果：干预组干预后PANSS各项评分均低于治疗前（认知行为组：t=3.882～6.697;家庭治疗组：t=4.765～9.608;职业康复组：t=2.956～5.111）,与治疗前比较,差异有统计学意义（P均〈0.01）;FBS总分、经济负担、家庭日常活动、家庭娱乐活动、家庭关系以及认知行为组的躯体健康因子分均低于治疗前（认知行为组：t=2.584～6.086;家庭治疗组：t=2.615～4.906;职业康复组：t=2.438～4.505）,与治疗前比较,差异有统计学意义（P〈0.05或P〈0.01）;干预组治疗前后差值方差分析显示,认知行为组的经济负担因子分的差值高于家庭治疗组和职业康复组,差异有统计学意义（F=3.984,P〈0.05）。结论：3种干预方法均能有效改善慢性精神分裂患者的精神症状、减轻患者家庭负担。Objective：To explore the effects of three interventions：cognitive behavioral therapy,family intervention and vocational rehabilitation intervention on outpatients and their family burden with chronic schizophrenia.Method：Two hundred of outpatients with chronic schizophrenia were randomly assigned to the cognitive behavioral therapy group,family intervention group,vocational rehabilitation intervention group and the control group.The corresponding treatments were given to the intervention group for one year.All the subjects were evaluated with positive and negative syndrome scale（ PANSS） and family burden scale of diseases（ FBS）.Results：The total score and factor scores of PANSS of three intervention groups decreased significantly after treatment（ P〈0.01）.The total score and factor scores（ family economy,family daily life,family entertainment activities,family relationship） of FBS of three intervention groups decreased significantly after treatment,and the physical health score of FBS of cognitive behavioral therapy group decreased significantly after treatment（ P〈0.05）.The difference of family economy score of FBS of Cognitive behavioral therapy group between pre and post treatment increased both in family intervention group and vocational rehabilitation intervention group（ P〈0.05）.Conclusion：Three interventions can significantly alleviate psychiatric symptoms of chronic schizophrenia and improve their family burden.

关 键 词：精神分裂症 家庭负担 干预方法 

分 类 号：R749.3[医药卫生—神经病学与精神病学]