恢复期精神分裂症患者再次复发住院的相关因素及早期表现特点

Early signs and related factors of schizophrenia relapse during the convalescent period

目的:调查精神分裂症患者再次复发住院的相关因素及其早期表现特点。方法:选择2002-06/09在山东省精神卫生中心住院的精神分裂症患者50例,男女各25例,均为可合作、对症状描述清楚、大体评定量表在71～80等级以上的再次住院患者,对入组患者及家属进行调查。按统一设计方案与患者交谈5～10min,调查本次复发的原因及早期情绪、行为、植物神经功能表现采用患者自我回答家属核实法,睡眠情况采用匹兹堡睡眠质量指数(共划分为主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、安眠药物的应用和日用功能7个成分,每个成分按0～3级计分,总分范围为0～21,以总分>7为界值来判断睡眠障碍,得分越高,表示睡眠质量越差)进行评定。对此次调查情况患者或其家属知情同意。结果:50例患者全部进入结果分析,无脱落。①复发因素:中断治疗占64%,工作压力大占50%,不能适应外界环境占30%,精神刺激诱发占46%,其他因素占22%。②早期情绪障碍表现:表现烦燥、脾气改变者分别占52%,50%,其次易激动、言语增多分别占42%,40%。③早期行为障碍表现:动作增多者占64%,表现纳呆占46%,揽镜、动作减少各占30%。④早期植物神经功能障碍表现:食欲减退者占62%,乏力者占58%,出虚汗者占44%。⑤早期睡眠障碍表现(匹兹堡睡眠质量指数得分):复发早期出现睡眠障碍者占88%。患者的平均分显著高于正常人犤14.14±4.15,3.88±2.52(t=17.48,P<0.01)犦。结论:精神分裂症患者的复发有多种因素,如未坚持治疗、工作压力大、不能适应外界环境以及其他的精神刺激等。复发的早期症状为精神病性与非精神病性症状的混合表现,其中以睡眠障碍和情绪障碍为主要特点。

AIM： To explore the early signs of schizophrenia and related factors for relapse in patients with schizophrennia. METHODS： Totally 50 schizophrenic inpatients （25 male and 25 female） in Shandong Mental Health Center from June to September 2002 were readmitted patients and consented for investigation. They were able to cooperate and can clearly describe the symptoms with general evaluation scales more than 71 to 80. Patients and their relatives were investigated. The reasons of relapse and the representation of early mood disorders, behavior symptoms, botanic neural function was investigated for about 5 to 10 minutes with the untively designed project .Sleep disorder was assessed by Pittsburgh sleep index（including sleep quality, sleep-onset time, sleep time, sleep efficacy, sleep disorders, use of sleep pills and daily functioning. Each factor was scored from 0-3. Total scores ranged from 0-21. Total scores 〉7 indicated sleep disorders. The higher the scores were, the poorer the sleep quality was）. Informed consent was obtained from the patients or relatives. RESULTS： Totally 50 patients all entered the result analysis with no loss.①Relapse factors： Intermitted treatment （64%）, high pressure from work （50%）, maladjusted to environment （30%）, mental stress （46%）, other factors （22%）. ② Early mood disorder： Early mood symptoms were upset （52%）, temper change （50%）, agitation （42%）, over-talkativeness （40%）. ③Early behavior disorder;over-activity（64%）,retardation（46%）,seeing mirror and decreased activity（30%）,④Early autonomic nervous system symptoms：poor appditite（62%）,fatigability（58%）,sweatful（44%）,⑤Early sleep disorder ： 88% of relapse patients showed early sleep disorders. Pittsburgh sleep quality index in patients were higher than those of normal people （14.14±4.15,3.88±2.52（t=17.48, P 〈 0.01 ）. CONCLUSION： The relapse of psychotics are often related to some factors, such as discontinue treatment, high pressure from work, maladjusted to environment and life events. The early symptoms include psychotic and nopsychotic symptoms; especially sleep disorders and mood disorders.