对社区慢性精神分裂症患者个体化康复治疗的近期效果

The short term efficacy of personalized rehabilitation treatment in chronic schizophrenics from community

目的探讨对慢性精神分裂症患者个体化康复治疗的近期效果。方法抽取上海市虹口区社区慢性精神分裂症患者,随机分为干预组和对照组;对干预组进行为期4月的个体化康复治疗;在基线收集一般资料,并在基线和干预结束后使用简明精神病量表(The Brief Psychiatric Rating Scale,BPRS)、副反应量表(Treatment Emergent Symptom Scale,TESS)、社会功能缺陷筛选量表(Social Disability Screening Schedule,SDSS)、日常生活能力量表(Activity of Daily Living Scale,ADL)、功能活动调查表(Functional Activites Questionaire,FAQ)、药物依从性以及不良反应报告(自制)等评定。结果入组的干预组20例和对照组14例,诊断均为精神分裂症,两组在年龄、性别、受教育程度、病程、住院次数、家族史均为统计学差异。基线两组的各个量表得分均无统计学差异,随访时两组在BPRS总分、BPRS缺乏活力因子两项存在统计学差异。干预组在个体化康复治疗后BPRS总分、BPRS缺乏活力因子、BPRS思维障碍因子、BPRS激活性、TESS、SDSS、FAQ共7项得分较治疗前分值降低。对照组在随访时仅有SDSS共1项得分较基线增高。结论个体化康复治疗能够改善慢性精神分裂症患者的精神症状和社会适应等社会功能,以及降低药物副反应。

Objective： To explore the short term efficacy of personal rehabilitation intervention in chronic schizophrenics from community. Methods： Some chronic schizophrenias in Hong Kou district were drew and randomly assigned into intervention group and control group. The intervention group received personal rehabilitation treatment for about 4 months. General information of two groups was collected at baseline. At baseline and following point, two groups schizophrenias were examined with BPRS（ The Brief Psychiatric Rating Scale, ） TESS （ Treatment Emergent Symptom Scale, ）, SDSS （ Social Disability Screening Schedule）, ADL （ Activity of Daily Living Scale）, FAQ （ Functional Activites Questionaire）, compliance for antipsychotic drugs and reports of adverse effects. Results：20 chronic schizophrenias were included in intervention group and 14 ones were included in control group, there are no significant difference in age, gender, education, courses of disease, hospitalization times and family histories between intervention group and control group. There are no difference in all examinations at baseline. At the following point, significant difference existed in the total scores and the deficiency energy factor scores of BPRS between two groups. 3. At following, there were decreasing in the scores of the total BPRS, the BPRS deficiency energy factor, the BPRSthinking disorder factor, the BPRS＇ activation factor,TESS, SDSS and FAQ for intervention group. Only the scores of SDSS increased for the control group at the following point. Conclusion： Personal rehabilitation treatment contribute to the controlling of psychiatric symptoms, the improvement of social function and the reducing antipsychotic drugs＇ adverse effects for chronic schizophrenias in community.