首发住院精神分裂症患者未治疗期的影响因素及其与临床疗效的相关性研究  

Study on the influencing factors of duration of untreated psychosis of first-time inpatients with schizophrenia and their correlation with clinical efficacy

作　　者：张开国 黄安延 黄燕虹 ZHANG Kaiguo;HUANG Anyan;HUANG Yanhong(Xiamen Xian Yue Hospital,Xiamen 361000,China)

机构地区：[1]厦门市仙岳医院,厦门361000

出　　处：《国际精神病学杂志》2020年第2期262-266,共5页Journal Of International Psychiatry

基　　金：广东高校升级重点平台和重大科研项目--特色创新类项目(编号:2018GXJK044);汕头市科技重点资助项目(编号:170817181930822);汕头市科技计划资助项目(编号:2019ST005)

摘　　要：目的探究首发住院精神分裂症患者未治疗期(duration of untreated psychosis,DUP)的影响因素及其与临床疗效的关系。方法搜集350例首发精神分裂症患者的临床资料,依据中位数48周将其分为短DUP组和长DUP组,探究DUP的影响因素,以及DUP对临床疗效的影响。结果男性患者平均首次就诊年龄为(30.01±11.98)岁,女性患者为(35.3±13.28)岁,存在统计学差异性(P<0.05),女性患者要明显晚于男性患者。短DUP组已婚患者77例(40.7%)明显多于长DUP组26例(17%)。短DUP组离异患者23例(12.2%)少于长DUP组38例(23.6%)。两组患者家族史存在统计学差异性(P<0.05),短DUP组患者中家族史阳性人数相对较多。两组患者烟酒史存明显差异,短DUP组烟酒史阴性患者170(89.9%)明显多于长DUP组126(78.3%)。两组患者诊断类型并不存在明显统计学差异性,但短DUP组紧张型12例(6.3%)明显多于长DUP组1例(0.6%),差异较明显。二元logistics回归分析发现婚姻状况、家族史、烟酒史以及临床类型对DUP有影响。对两组出院BPRS量表总分进行对比,发现短DUP组较长DUP组评分明显较低(P<0.001)。BPRS量表治疗前后评分差值反映临床疗效,短DUP组评分差值(19.50±5.73)与长DUP组(11.06±4.27)存在显著差异(P<0.001),提示长DUP组患者临床疗效相对较差。结论婚姻状况、家族史、烟酒史以及临床类型与DUP之间存在相关性,随着DUP的延长,患者临床疗效显著降低。Objective To explore the influencing factors of duration of untreated schizophrenia(DUP)and its relationship with clinical efficacy. Methods The clinical data of 350 first-episode schizophrenics were collected and divided into short DUP group and long DUP group according to the median 48 weeks. Results The average age of first visit was(30.01±11.98)years for male patients and(35.3±13.28)years for female patients,with statistical difference(P<0.05). 77 married patients(40.7%)in the short DUP group were significantly more than 26(17%)in the long DUP group. 23 cases(12.2%)in short DUP group were less than 38 cases(23.6%)in long DUP group. There was significant difference in family history between the two groups(P<0.05). There was significant difference between the two groups in tobacco and alcohol history. 170(89.9%)patients with negative tobacco and alcohol history in the short DUP group were significantly more than 126(78.3%)patients in the long DUP group. There was no significant difference in diagnosis type between the two groups,but 12 cases of tension type in the short DUP group(6.3%)were significantly higher than 1 case in the long DUP group(0.6%). Binary logistic regression analysis showed that marriage status,family history,tobacco and alcohol history,and clinical types had influence on DUP. Compared the total score of BPRS in the two groups,it was found that the score of BPRS in the long DUP group was significantly lower in the short DUP group(P<0.001). The difference of BPRS scores before and after treatment reflected the clinical efficacy. There was a significant difference between the short DUP group(19.50±5.73)and the long DUP group(11.06±4.27)(P<0.001),suggesting that the long DUP group had relatively poor clinical efficacy. Conclusion There is a correlation between DUP and marital status,family history,tobacco and alcohol history,and clinical types.

关 键 词：精神分裂症 未治疗期 影响因素 临床疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]