精神分裂症综合式家庭治疗──63例前瞻性单盲随机对照研究

Comprehensive family treatment for schizophrenic patients: A prospective,randomized, dingle -blind control trial of 63 patients

作者采用前瞻性单盲对照研究，将符合ＤＳＭ－Ⅲ－Ｒ精神分裂症诊断标准的６３例病人随机分成两组，实验组接受作者发展的包含药物治疗、家庭干预、心理教育在内的综合式家庭治疗；对照组接受普通门诊治疗。平均随防２年时的盲法评定结果表明：综合式家庭治疗能有效地减少临床复发、降低再住院率、缩短再住院时间、提高患者的社会功能、减轻家庭的经济和精神负担，并具有良好的社会效益，有推广价值。

A five -year,prospective study is undertaking to assess a comprehensive, ongoing intervention special-ly develoed by the authors for Chinese urban families of schizophrenic patients.This paper reports interim results of this study.Sixty-three urban patients who met DSM-IIIR diagnostic criteria for schizophrenia and who live with family members were enrolled at the time of admission to hospital and were randomly assigned to the standerd care (comtrol)group or the family -based intervention (experimental)group. The experimental intervention includes monthly 45-minute counselling sessions focused on the management of social and occupatior problems, medication managment .familyeducatiopn.family group meetings,and cris intervention.Standard care usually entails sporadic attendance at the outpatient clinic for renewal of medication. After an average of two years of post -hospitalization follow -up the proportion of subjects who relapsed was low-er,the mean duration of rehospitalization was shorter,the duration of gainful employment was longer,and the overall level of social disability and family burden were lower in the experimental group than in the control group. considering all direct and indirect treatment costs and the loss of income from employment .the family -intervention method costan average of 1,330 Renminbi ($US 153) LESS per year than standard care;this is 85%of the 1992 per capita yearly income for urban residents.Given that this family treatment would be acceptable an estimated 1.06 millioa urban families with schizophrenic family members, if could ,if employed in all Chinese cities,result in a saving of 1.4 billionRenminbi($US 161 million )Per year.