社区慢性精神分裂症家庭干预随访研究

Family Intervention of Chronic Schizophrenics in Community: A Follow-up Study

目的 :探索提高社区慢性精神分裂症康复效果 ,降低成本的有效服务形式。方法 :采用前瞻性研究 ,把 2 2 5例精神分裂症患者随机分入干预组和对照组进行历时二年的随访研究。结果 :干预组患者的复发率、PANSS减分率、DAS减分率和干预组家属的SAS、CES -D总分减分率等均显著优于对照组。成本效益分析干预组家庭平均每户年投入 36 0元 ,干预组康复的直接与间接成本比对照组低 46 0 19元 ,患者或家属复工增加的收入比对照组多 6 33 75元 ,效益成本比值 (BCR)为 3 0 4,净效益 (NB)为 733 94元。结论 :家庭干预能有效降低精神裂症康复的直接、间接成本和隐性成本 ,能有效降低疾病的复发率 ,提高疗效和社会功能 。

Objective: To explore effective service model for improving rehabitlitative efficacy and lowering cost. Methods: Based on prospective cohort study design, 225 schizophrenic patients were randomly divided into intervention group and control group, and were followed up for two years. Self-design health economic scale and PANSS, DAS, SAS were administered to patients and their family members. Results: The relapse rate, the reduction rate of PANSS and DAS of the patients in intervention group as well as the reduction rate of SAS and CES-D total score of their family members were superior to those of control group. Cost-benefit analysis showed that the intervention group had less costs and more income, possessed better benefit/cost ratio (3.04) and net benefit. Conclusions: Family intervention can lower the direct and indirect costs of rehabilitation of schizophrenia, decrease the relapse rate of the disease and improve treatment efficacy and social function effectively.