精神分裂症患者精神残疾状况、影响因素及对生活质量的影响  

Mental Disability Status,Influencing Factors and Their Impact on Quality of Life in Patients with Schizophrenia

作　　者：邢字航 甄晓红 李雅彤 任利民[1] 孙岩 XING Zihang;ZHEN Xiaohong;LI Yatong;REN Limin;SUN Yan(The Third Department of Psychiatry,the Eighth Hospital of Shijiazhuang City,Shijiazhuang 050000,China;Department of Psychiatry,Shijiazhuang People's Hospital,Shijiazhuang 050000,China;Department of Public Health,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第八医院精三科,石家庄050000 [2]石家庄市人民医院精神科,石家庄050000 [3]石家庄市中医院公共卫生科,石家庄050000

出　　处：《临床误诊误治》2024年第7期54-59,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会医学科学研究项目(20221653)。

摘　　要：目的探究精神分裂症患者精神残疾状况、影响因素及其对生活质量的影响。方法选取2020年12月—2022年12月收治的250例精神分裂症,根据世界卫生组织残疾评定量表Ⅱ(WHO DASⅡ)评分分为精神残疾组210例和非精神残疾组40例。比较2组临床资料,入院1个月后的简明精神病评定量表(BPRS)和患者积极度量表(PAM)评分;采用世界卫生组织生活质量评定量表简表(WHOQOL BREF)评分比较2组入院1个月后的生活质量;采用受试者工作特征(ROC)曲线分析相关指标对精神分裂症患者精神残疾发生的诊断价值;采用多因素Logistic回归分析影响精神分裂症患者发生精神残疾的危险因素;采用Pearson相关性分析相关评分与WHO DASⅡ评分的关系。结果精神残疾组较非精神残疾组病程更长,复发次数更多,家庭氛围不和谐及偏执型人数占比更大,已婚人数占比更少,受教育年限更短,月收入更低(P<0.05,P<0.01)。精神残疾组BPRS评分高于非精神残疾组,WHOQOL BREF和PAM评分低于非精神残疾组(P<0.01)。ROC曲线分析结果表明,病程、复发次数、受教育年限、月收入、BPRS评分、WHOQOL BREF评分和PAM评分对精神分裂症患者精神残疾的发生具有良好的诊断价值(P<0.01)。多因素Logistic回归分析显示,复发次数多、家庭氛围不和谐、BPRS评分过高、WHOQOL BREF评分过低是影响精神分裂症患者发生精神残疾的独立危险因素(P<0.01)。Pearson相关性分析显示,BPRS评分与WHO DASⅡ评分呈正相关性(r=0.899,P<0.001),WHOQOL BREF评分与WHO DASⅡ评分呈负相关性(r=-0.886,P<0.001)。结论复发次数多、家庭氛围不和谐、BPRS评分高、WHOQOL BREF评分低均能促使精神分裂症患者发生精神残疾,且患者精神残疾状况及影响因素对其生活质量影响显著。Objective To explore mental disability status,influencing factors and their impact on quality of life in patients with schizophrenia.Methods In total,250 patients with schizophrenia were selected.According to scores of World Health Organization Disability Assessment ScheduleⅡ(WHO DASⅡ),patients were divided into mental disability group(n=210)and non-disability group(n=40).The clinical data,scores of the Brief Psychiatric Rating Scale(BPRS)and Patient Activation Measure(PAM)at admission were compared between the two groups.The quality of life at 1 month after admission in the two groups was compared by World Health Organization Quality of Life-BREF(WHOQOL BREF).Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of relevant indicators for the occurrence of mental disability in patients with schizophrenia.The risk factors of mental disability were analyzed by Logistic regression analysis.The relationship between the related scores and WHO DASⅡscore was analyzed by Pearson correlation analysis.Results Compared with non-disability group,course of the disease was longer,recurrence frequency and proportions of cases with family disharmony and intolerance style were higher,proportion of married cases was lower,the years of education was shorter and monthly income was lower in mental disability group(P<0.05,P<0.01).BPRS score in mental disability group was higher than that in non-disability group,while WHOQOL BREF and PAM scores were lower than those in non-disability group(P<0.01).The results of ROC curve analysis indicated that the course of disease,recurrence frequency,years of education,monthly income,BPRS score,WHOQOL BREF score,and PAM score had good diagnostic value for the occurrence of mental disability in patients with schizophrenia(P<0.01).The results of multivariate Logistic regression analysis showed that higher frequency of recurrence,family disharmony,higher BPRS score and lower WHOQOL BREF score were all independent risk factors of mental disability in patients with

关 键 词：精神分裂症 精神残疾 影响因素分析 生活质量 残疾评定量表Ⅱ 简明精神病评定量表 世界卫生组织生活质量评定量表简表 相关性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]