精神分裂症患者随访1年的复发规律及因素探讨  

Regularity and Factors of Relapse on Schizophrenia After One-year Follow Up

作　　者：闫丽琼[1] 冯萍[1] 马良[1] 

机构地区：[1]北京市朝阳区第三医院,100121

出　　处：《中国健康心理学杂志》2017年第5期663-666,共4页China Journal of Health Psychology

基　　金：北京市朝阳区科学技术委员会课题(编号:SF1221)

摘　　要：目的:探讨精神分裂症患者的复发因素及1年的复发规律。方法:采用自编调查问卷及阳性与阴性症状量表,对2013年1-12月期间我院出院的90例精神分裂症患者在出院当天进行问卷评估,在出院后的3、6、9、12个月进行随访。结果:1研究结束时,24例患者病情复发住院。1年的复发率为26.67%;2复发与未复发患者一般情况及阳性与阴性症状量表比较,病程(Z=-2.078,P<0.05)、住院次数(Z=-4.004,P<0.05),出院时阳性与阴性量表一般精神病理分(Z=-2.907,P<0.05)差异显著;3二元Logistic回归分析发现,住院次数和一般精神病理分是复发入院的影响因素(P<0.05),住院次数是复发的危险因素(OR=0.749,95%CI=0.61~0.90),一般精神病理分是复发入院的保护因素(OR=1.139,95%CI=1.02~1.26)。患者在第3、6、9、12个月的累积复发率分别为5.56%(5/90),12.22%(11/90),21.11%(19/90),26.67%(24/90)。对不同时点的复发率进行曲线拟合,曲线拟合优度为R2=0.995,拟合优度良好,说明患者的复发率呈上升的趋势。结论:1患者既往的住院次数,阳性与阴性量表分中的一般精神病理分是复发入院的影响因素,减少入院次数,可以减少患者的复发;2患者1年内的复发率呈上升趋势,如何对出院患者进行积极有效干预,是今后预防复发的工作重点之一。Objective：To explore factors and rules of relapse in schizophrenia patients by 1 year follow up.Methods：Using the self—made questionnaire and the positive and negative symptoms scale（PANSS）to evaluate 90 patients who were departing from hospital,then they were followed up in the third month,sixth month,ninth month,twelfth month after discharged.Results：① At the end of study,90patients finished the investigate.24 patients relapsed,the 1 year relapse rate was 26.67%（24/90）.② There were significant differences between patients who relapsed and who not in the course of disease（Z=-2.078,P〈0.05）,admission times（Z=-4.004,P〈0.05）,the general psychopatho-logical score of PANSS（Z=-2.907,P〈0.05）.③The Binary Logistic regression analysis suggested that admission times and the general psychopathological score were factors that influenced relapse.Admission times（OR=0.749, 95%CI=0.61-0.90）was risk factor of relapse,the general psychopathological score（OR=1.139,95%CI=1.02-1.26）was the protective factor of relapse.The cumulative relapse rate of the third month,the sixth month,the ninth month,the twelfth month was 5.56%,12.22%,21.11%,26.67%.After the curve fitting of the relapse rate of all the time points,the goodness of the fit was R？ =0.995.Conclusion：1The admission times,the general psychopathologi-cal score are factors that influence relapse,reducing admission times can reduce relapse;2The relapse rate increases gradually during one year,to give effective intervention to discharged patients is one of the important work to reduce relapse.

关 键 词：精神分裂症 复发 相关因素 阳性和阴性症状量表 

分 类 号：R749.3[医药卫生—神经病学与精神病学]