精神分裂症病人维持治疗中的依从性研究

Compliance in schizophrenic maintenance treatment

为了研究门诊精神分裂症病人在维持治疗中的依从性，对３９７例门诊精神分裂症病人在维持治疗中的服药依从性采用直接面询法进行了研究。结果显示，完全依从的有２９９例，占７５．３％，部分依从和不依从的有９８例，占２４．７％。＞３０岁组的依从性较≤３０岁组的好（Ｐ＜０．０１），家庭人际关系好的病人依从性优于家庭人际关系差的病人（Ｐ＜０．０１），目前精神症状严重的病人、维持治疗药物剂量（折合氯丙嗪剂量）＞３００ｍｇ／ｄ的病人、ＭｏｒｎｉｎｇＳｉｄｅ康复状态量表评分高的病人依从性差。经逐步多元回归分析，影响服药依从性的主要因素为：家庭人际关系、维持治疗药物剂量、维持治疗时间、慢性精神病病人标准化精神症状量表评分。认为提高病人的依从性能减少疾病的复发。

To study the compliance of schizophrenic patients in maintenance treatment, 397 out patients was assessed with face to face interview. The results showed that 299 patients (75.3%) were of full compliance, and 98 cases (24.7%) were of partial compliance or non compliance. The patients aged over 30 years had a better compliance than those younger than 30 ( P <0.01). The cases with better interpersonal relationship within family had a better compliance than those with a worse one ( P <0.01) and those with severer current psychiatric symptoms, with maintenance dosage higher than 300 mg/d (equivalent to chlorpromazine), and with a higher score in Morning Side Recovery Status Scale had a worse compliance. Stepwise multifactorial regression analysis revealed the major factors related to compliance were as follows: interpersonal relationship within family, maintenance antipsychotic dosage, duration of maintenance treatment and scores in chronic schizophrenics standardized psychiatric symptom scale. The results indicate that enhance of compliance may decrease the relapse in patients with schizophrenia.