综合干预对康复期精神分裂症患者疗效的随访研究

A follow-up study about the effect of comprehensive intervention on rehabilitative schizophrenia patients

目的探索生物-心理-社会综合干预对康复期精神分裂患者的疗效及在国内精神科领域率先尝试慢性病自我管理模式。方法研究对象为我院3个治疗病房的患者,出院前1月对干预组患者和家属实施综合干预,对照组按正常治疗出院,评定两组患者出院时的阳性阴性症状量表(PAN-SS)和大体评定量表(GAS)。干预组出院后进行定期的电话和上门随访,对照组一般门诊随访,3个月、6个月、1年时再分别对两组患者做PANSS量表、GAS、MRSS康复状态评定量表、SDSS社会功能缺陷筛选量表的测定。结果干预组经综合干预后PANSS量表、MRSS、SDSS分值逐步下降,GAS分值升高,与对照组比较差异显著;干预组服药依从性、自觉门诊随访率显著高于对照组,再住院率低于对照组(P<0.01)。结论对康复期精神分裂症患者进行综合干预可以提高临床疗效、改善阳性症状、提高社会功能并能增加服药依从性,减少复发。

Objective To explore the effect of biologic-mental-social comprehensive intervention on rehabilitative schizophrenia patients. To attempt the Chronic Disease Self-Management mode in domestic psychiatry. Methods The objects are the patients hospitalized in our center, the comprehensive intervention was carried out on patients of interventional group and their family members 1 month prior to discharge. Control group were given common treatment. The two group patients were evaluated by Positive and Negative Syndrome Scale （PANSS） and Global Assess Scale （GAS）. Interventional group patients were followed up by regular telephone or visiting, the control group were followed up only by clinic. The PANSS,GAS,MRSS and SDSS were used to evaluate the two group on the third month, half year and one year. Results The PANSS,MRSS and SDSS score of interventional group decreased and the GAS score increased significantly compared with controls. The medicine compliance and clinic follow up rate of interventional group are higher than those of controls, the rehospitalization rate of in tervention group are lower than that of controls （P〈0.01）. Conclusions The comprehensive intervention on rehabilitative schizophrenia patients can enhance the therapeutic effect and social function, improve negative symptoms, increase the compliance of medicine and reduce the probability of relapse.