内观疗法与行为疗法对精神分裂症患者近期服药依从性的影响

Effect of Naikan therapy and behavioral therapy on recent medication adherence in schizophrenic patients

目的:探讨内观疗法和行为疗法对精神分裂症患者近期服药依从性的影响。方法:161例住院的精神分裂症患者随机分为内观+行为组(39例,住院时内观治疗,出院后行为治疗)、内观组(41例,住院时内观治疗)、行为组(37例,出院后行为治疗)及对照组(44例,无内观及行为治疗);用药片计数法比较各组患者出院后12周服药依从性。结果:12周后服药完全依从、部分依从和不依从内观+行为组分别为32例、4例、3例,内观组为18例、11例、12例,行为组为16例、12例、9例,对照组为6例、13例、25例;各组间差异有统计学意义(χ2=43.50,P<0.0001);服药完全依从率内观+行为组明显高于其他3组,内观组及行为组明显高于对照组(P均<0.01)。结论:内观疗法和行为疗法均能提高患者的近期服药依从性,两者结合效果更佳。

To investigate the effect of Naikan therapy and behavioral therapy on recent medi-cation compliance in schizophrenic patients. Method：One hundred and sixty-one schizophrenic patients were randomly assigned into 4 groups：Naikan ＋ behavioral therapy group（39 cases,treated with Naikan therapy in hospitalization and behavioral therapy after discharge）,Naikan therapy group（41 cases,treated with Naikan therapy in hospitalization）,behavioral therapy group（37 cases,treated with behavioral therapy after dis-charge）,control group（44 cases,treated as usual）. The medication adherence among the 4 groups was com-pared by pills counting method until 12 weeks after discharge. Results：After 12 weeks,the cases of full com-pliance,part of compliance and non compliance were 32,4 and 3 in Naikan ＋ behavioral therapy group;18,11 and 12 in Naikan therapy group;16,12 and 9 in behavioral therapy group;6,13 and 25 in control group,re-spectively. The rates of fully compliance were significant difference among the 4 groups（ χ2 = 43. 50,P ﹤0. 0001）. The medication compliance rate in Naikan ＋ behavioral therapy group was significantly higher than in other 3 groups;that in Naikan therapy group and behavioral therapy group were significantly higher than in con-trol group（all P ﹤ 0. 01） Conclusion：Either Naikan therapy or behavioral therapy can improve the recent medication compliance in schizophrenic patients. Combination of the two therapies can be better.