110例精神分裂症社区防治前瞻性研究

A Prospective Study for Prevention and Treatment of 110 Patients with Schizophrenia in the community

目的探索社会化开放式的社区防治精神分裂症的康复效果。方法从厂职工病例中抽取符合中国精神障碍分类与诊断标准第3版精神分裂症诊断标准和国际疾病分类第10版精神分裂症诊断标准的110例精神分裂症患者进行二年社区防治,成立课题协作组,邀请工厂领导座谈,培训专职医师,医疗监护相结合的防治网络,实施家庭干预、劳动康复、服药监护,与专职医师、单位和家庭联系。结果期末评估,入组患者1～20项、21～40项减分率为45.0%和64.1%,SDSS减分率53.5%,评残五题减分率49.8%(P<0.01)。精神分裂症患者复发率,住院率和肇事率明显下降(P<0.01)。结论社区防治对精神分裂症具有较好的康复效果。投入较少,操作简便,患者家庭愿意接受,基层医师易于掌握,适宜城乡推广。

Objective To investigate the rehabilitation outcome for schizophrenia with socializing and open community prevention and treatment.Methods According to the Chinese Classification and Diagnostic Criteria of Mental Disorders（CCMD-3）and the International Classification of Diseases（ICD-10）,110 patients with schizophrenia were extracted to particle involve in two-year community prevention and treatment.Investigators established topic cooperation group,invited leaders to have a discussion,trained full-time physicians,form prevention and treatment network with medical treatment and monitor,implement family intervention,work rehabilitation,monitor for administration of drugs and contact with full-time physicians,the unit and families.Results In final evaluation,the reducing score rate with 1-20 items and 21-40 items in enrolled patients was 45.0% and 64.1%,respectively,with SDSS of 53.5%,and the five items evaluating disability was 49.8%（P〈0.01）.The recurrence rate,hospitalization rate and accident rate decreased obviously in patients with schizophrenia.Conclusion Community prevention and treatment for schizophrenia showed better rehabilitation outcome.Due to less investment,easier operation,willing to accept for families,easy to grasp for primary physicians,this measure is suitable for wide promotion in cities and countryside.