社区综合干预对精神分裂症患者康复、社会功能及社会经济效益影响的研究  

The effect of community-based comprehensive intervention on rehabilitation,social function,social and economic benefits of schizophrenic

作　　者：李志武[1] 李斌[2] 何燕[3] 康瑞莹 刘世红[1] 吴业清 LI Zhiwu;LI Bin;HE Yan(Beijing Fengtai Nanyuan Hospital,Beijing 100076,China)

机构地区：[1]北京市丰台区南苑医院,北京100076 [2]首都医科大学附属安定医院 [3]首都医科大学 [4]北京市丰台区丰台社区卫生中心

出　　处：《国际精神病学杂志》2018年第5期847-850,共4页Journal Of International Psychiatry

基　　金：首都卫生发展科研专项项目(编号:2014-3-7053)

摘　　要：目的探讨社区综合干预对精神分裂症患者康复、社会功能及社会经济效益的影响。方法取2014年6月~2017年5月丰台社区中在册管理的社区患者300例,随机数字法分为药物治疗组(OMT组,n=100)、药物治疗结合心理教育治疗组(MCP组,n=100)及药物结合心理教育及技术培训治疗组(MCPS组,n=100)。OMT组采用齐拉西酮、利培酮治疗,MCP组在OMT组基础上联合心理教育治疗,MCPS组在OMT组、MCP组基础上联合技术培训治疗,采用社会功能缺陷评定量表(SDSS)及阳性及阴性症状(PANSS)对2组治疗前、后社会功能进行评估,通过现场组织活动谈话和问卷、电话联系方式收集患者社会经济效益。结果 MCPS组治疗依从率为97.00%,MCP组治疗依从率87.00%,OMT组治疗依从率为82.00%,3组治疗依从率比较差异有统计学意义(P<0.05);MCPS组治疗后6个月SDSS及PANSS量表评分,均低于MCP组和OMT组(P<0.05);MCP组治疗后6个月SDSS及PANSS量表评分,均低于OMT组(P<0.05);MCPS组治疗后6个月直接成本与间接成本,均低于MCP组和OMT组(P<0.05);MCP组治疗后6个月直接成本与间接成本,均低于OMT组(P<0.05)。结论将社区综合干预用于精神分裂症患者中效果理想,值得推广应用。Objective To explore the effect of community-based comprehensive intervention on rehabilitation,social function,social and economic benefits of schizophrenics. Methods from June 2014 – May 2017,300 patients managed from Fengtai community were randomly divided into the treatment group（group OMT,n=100）,the drug therapy combined with psychological education treatment group（group MCP,n=100）and the drug combined with psychological education and technical training treatment group（group MCPS,n=100）. The OMT group was treated only with ziprasidone and risperidone in the treatment group,the MCP group added psychological therapy,the MCPS group added psychological therapy and treatment of technical training. The social disability rating scale（SDSS）and the positive and negative symptoms（PANSS）were evaluated in 2 groups before and after treatment,social function with the social and economic benefits,collected through on-site activities questionnaire,telephone contact and conversation. Results The MCPS group treatment compliance rate was 97%,the rate of compliance with the MCP group was %,the OMT group treatment compliance rate was 82%. The treatment compliance rate difference between the 3 groups have statistical significance（P〈0.05）. In the MCPS group, SDSS and PANSS score were lower than MCP group and OMT group after 6 months after treatment（P〈0.05）. In the MCP group,,SDSS and PANSS score were lower than those in group OMT at 6 months after treatment（P〈0.05）. At 6 months treatment,the direct cost and indirect cost of the MCPS group were lower than those of the MCP group and the OMT group（P〈0.05）;and the direct cost and indirect cost of the MCP group after treatment were lower than those in group OMT（P〈0.05）. Conclusion Community-based comprehensive intervention is ideal for schizophrenia patients and is worthy of popularization and application.

关 键 词：社区综合干预 精神分裂症 社会功能 社会经济效益 治疗依从性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]