个案管理模式对首发精神分裂症康复效果研究

Rehabilitation effect of case management model of schizophrenia in first-episode spirit

目的探讨个案管理模式对首发精神分裂症的康复效果。方法将120例出院的首发精神分裂症患者按出院顺序随机分为个案管理组(观察组)60例,传统门诊随访组(对照组)60例,进行两年的随访研究。在基线和入组后6、12、18、24个月时采用阳性与阴性症状量表(PANSS)、社会功能缺陷量表(SDSS)评定患者的病情、社会功能;24个月时记录复发率、再住院率及再就业率。结果两组在基线时PANSS总分、SDSS评分差异均无统计学意义(P>0.05);在6、12、18、24个月观察组PANSS总分、SDSS评分均明显低于对照组(P<0.05或P<0.01);观察组的复发率为8.33%、再住院率为5.00%,均明显低于对照组的38.33%和26.67%,再就业率为53.33%,明显高于对照组的28.33%,差异均有统计学意义(P<0.05)。结论个案管理模式能有效提高首发精神分裂症患者的疗效,改善其社会功能、降低复发率、提高再就业率。

Objective To study the rehabilitation effect of case management model of schizophrenia in first-episode spirit. Methods One hundred and twenty cases of first-episode schizophrenic patients discharged by the discharge order were randomly divided into case management group （observation group 60 cases） and conventional outpatient follow-up group （control group, 60 cases）, and were followed up for 2 years. The patient＇s condition, social function, 24 months recording the relapse rate, re-hospitalization rate and re-employment rate were assessed by posi- tive and negative symptom scale （PANSS）, social disability scale （SDSS） at baseline or 6, 12, 18 and 24 months after being grouped, respectively. Results At baseline, there were no significant difference in PANSS and SDSS scores be- tween the two groups （P〉0.05）. At 6, 12, 18, 24 months after being grouped, the PANSS and SDSS scores in the obser- vation group were significantly lower than those in the control group （P〈0.05 or P〈0.01）. The relapse rate and re-hos- pitalization rate in the observation group were significantly lower than those in the control group （8.33% vs 38.33%, 5.00% vs 26.67%, P〈0.05）. The re-employment rate in the observation group was significantly higher than that in the control group （53.33% vs 28.33%, P〈0.01）. Conclusion The effect of case management model can effectively improve the first-episode schizophrenia, the re-employment rate and social function, and reduce the recurrence rate.