广州市越秀区重性精神病肇事肇祸倾向者社区干预模式研究

Study on the Model of Community Intervention on the Patients with Severe Psychosis Who Have Tendency of Making Trouble,Yuexiu District,Guangzhou City

[目的]探索和建立有重性精神病肇事肇祸倾向者社区干预模式,以便降低疾病复发,减少疾病负担,降低肇事肇祸危险。[方法]2010～2012年,在广州市越秀区5条行政街确诊为精神分裂症、心境障碍、分裂情感性精神病、偏执性精神障碍患者中抽取有肇事肇祸危险倾向的1～5级患者139例进行社区干预,并在干预前、接受干预2年时分别使用肇事肇祸危险度评估表、生活质量量表、简明精神病量表、社会功能缺陷筛选量表(SDSS)和Zarit护理者负担量表进行调查与评价。[结果]干预2年时与干预前比较,139例患者的暴力行为等级下降(P<0.05),简明精神病量表评分别为45.19±17.77、31.55±11.67分(P<0.01),社会功能缺陷筛选量表评分为24.01±14.83、18.93±12.83分(P<0.01),Zarit护理者负担量表评分为48.69±13.86、45.56±15.18分(P<0.05),生活质量量表评分为18.84±2.54、18.60±2.50分(P>0.05)。[结论]对重性精神病患者的社区干预措施的效果是显著的。

[Objective]To explore and establish severe psychotic community intervention model, who have the tendency of troublemaking,in order to ease the burden of disease, reduce the mental disease relapse rate and the risk of troublemaking. [Methods] The patients of the schizophrenia,mood disorder, schizoaffective psychosis and paranoid disorder （rough stuff grading standards 1-5 levels） from five streets in Yuexiu district were selected as the objects of study,and the community intervention was implemented for two Years. The patients were investigated and evaluated with scales before being intervened and over 2 years, which were evaluative troublemaking scale, the changing values of quality of life scale, the Brief Psychiatric Rating Scale, Social Disability Screening Schedule and the score of Zarit Caregiver Burden Interview. [Results]Compared to the previous, the violence level in patients significantly decreased after two years intervention（ P 〈 0.05）. The score of The Brief Psychiatric Rating Scale decreased from. 45.19 ± 17.77 points to 31.55 ± 11.67 points（ P 〈0.05）. The score of Social Disability Screening Schedule decreased from 24.01± 14.83 points to 18.93± 12.83 points（ P 〈0.05）. The score of Zarit Caregiver Burden Interview decreased from 48.69 ± 13.86 points to 45.56± 15.18 points （ P 〈0.05）. The score of Quality of Life Scale was 18.84±2.54 and 18.60± 2.50（ P 〉0. 05）. [Conclusion]The effect of the severe psychotic community intervention is significant.