首发精神分裂症早期干预的康复效果

Rehabilitation of early intervention to first episode schizophrenia

目的 探讨早期干预措施对首发精神分裂症患者的康复效果。方法 将 6 2例首发男性精神分裂症住院患者随机分为干预组 (30例 )和对照组 (32例 ) ,在利培酮治疗的同时 ,对干预组予以心理社会干预措施 ,观察时间为 8周 ,出院后随访 6个月。用阴性、阳性症状评定量表 (PANSS)、住院病人护士观察量表 (NOSIE 30 )和复发率进行评估。结果 入组时与随访最后时点评分差值的比较 ,干预组患者的PANSS总分 (4 6 37± 13 6 5 )、阳性症状分 (18 2 4± 5 83)、阴性症状分 (14 5 5± 5 4 0 )均优于对照组 (分别为 4 1 5 9± 14 6 3、15 30± 6 2 2、19 84± 7 36 ,P <0 0 5～P <0 0 1) ;干预组患者的积极因素分 (- 38 6 5± 9 79)、消极因素分 (31 0 2± 12 5 3)、总评估分 (- 6 6 30± 14 4 5 )皆显著优于对照组 (分别为 - 9 6 7± 11 2 3、3 18± 14 4 7、- 11 6 2± 2 3 75 ,P均 =0 0 0 0 ) ;干预组的复发率 (6 6 7% )低于对照组 (18 75 % ) ,但差异无显著性。结论 对首发精神分裂症患者早期干预措施 ,能较好改善患者的精神症状、提高社会功能、降低复发率 。

Objective: To detect the rehabilitation of early intervention to first episode schizophrenia. Methods: 62 male patients with first episode schizophrenia were randomly divided into the intervention group and the control group, 30 in each group. They were treated with risperidone and the patients of the intervention group were given psychological and social intervention. The study was conducted for 8 weeks and followed up for six months and was evaluated with the Positive and Negative Symptoms Scale (PANSS), Nurse Observation Scale for Inpatient Evaluation (NOSIE) and the relapse rate. Results: There were significant difference between the intervention group and the control gruop in the total PANSS score, positive symptom score, the negative symptom score before and after the treatment ( P <0 05～0 01); there were significant difference between the two groups in the positive factors scores, the negative group and the total score. The relapse rate of the intervention group (18.75%) was lower than that of the control group (6.67%), but there was no significant difference. Conclusion: Early intervention to first episode schizophrenia could improve psychiatric symptoms and social functions and lower the relapse rate.