社区精神分裂症患者暴力行为家庭干预效果评价

Effects of family intervention on aggressive behavior of schizophrenics in community

目的探讨家庭干预对控制社区精神分裂症患者暴力攻击行为的效果,观察家庭干预对精神分裂症患者的病情、生活质量、家庭关怀度的影响。方法将研究对象随机分为干预组和对照组各50例,干预组给予家庭干预+常规抗精神病药物治疗,对照组仅给予常规抗精神病药物治疗;运用阳性和阴性症状评定量表(PANSS)、攻击行为问卷(MOAS)、生活质量指数问卷(QL-Index)、家庭关怀度指数问卷(Family APGAR Index)及治疗中的症状量表(TESS)等量表评估2组入组前后1年内的攻击行为及病情变化等情况。结果研究组在入组后各随访期内的攻击行为问卷评分明显低于对照组(P<0.01),在入组后第12个月,干预组MOAS均分为(1.06±0.65)分较对照组(8.12±2.32)分低,差异有统计学意义;干预组的PANSS评分自入组后第2个月开始明显低于对照组,干预组在入组后1年内总住院例次为14例次明显低于对照组26例次(P<0.01);QL-Index、Family APGAR Index评分在入组后各随访期均明显高于对照组(P<0.01)。结论社区精神分裂症患者发生暴力攻击行为的危险性较高,家庭干预能有效减少社区精神分裂症患者的暴力攻击行为,有利于患者病情恢复,提高生活质量,值得临床推广应用。

Objective To investigate the effects of family intervention on aggressive behavior, life quality, and family care of schizophrenics in community. Methods A total of 100 schizophrenics （ diagnosed based on the International Classification of Disease, 10th Revision I ICD - 10 ] ）in community were randomly divided into two groups. Fifty patients in study group were subjected to family intervention and conventional antipsychotics, while 50 patients in control group were only treated with conventional antipsychotics. All patients were followed-up and assessed with aggressive behavior questionnaire, Modified Over Aggression Scales （ MOAS ）, Positive and Negative Symptom Scale （ PANSS ）, Quality ofLife Index Questionnaire （ QL-Index ）, Family Adaptation Partnership/Growth/Affection/Resolve （ APGAR ） Index, and Treatment Emergent Symptom Scale （TESS）before and one year after the follow-up. Results The total number of attack and MOAS score for patients in the study group were significantly lower than those in the control group at each follow-up assessment during one year period（P 〈0. 01 ）. The PANSS score in the study group was lower than that in the control group from the second month of the follow-up. The total hospital attendance（14） in the study group was lower than that （26） in control group during one year period. The scores of QL-Index and Family APGAR Index in the study group were higher than those in the control group at each follow-up assessment（P 〈 0. 01 ）. Conclusion The risk of aggressive be- haviors for schizophrenics in community is quite high. Family intervention can effectively reduce the severity of aggres- sive behaviors of community schizophrenics, and improve life quality of the schizophrenics.