晚发性分裂症患者回归社会多因素分析

The Related Factors Impacting Prognosis of Late-onset Schizophrenia

目的探讨影响晚发性分裂症患者回归社会的因素。方法收集2006-2013年首次住院的晚发性(起病年龄>45岁)分裂症患者(研究组)62例和同期首次住院的精神分裂症患者(对照组)60例,采用自制一般情况调查表、社会功能缺陷量表(SDSS)、日常生活能力量表(ADL)及大体评定量表(GAS),以随访与量表现场测评相结合的方法获得资料,数据采用多因素回归分析。结果 1研究组服药依从性好于对照组(χ2=5.208,P<0.05);复发率低于对照组(χ2=4.504,P<0.05);2研究组预后良好者显著高于对照组(χ2=9.360,P<0.05);3研究组的社会功能和日常生活能力优于对照组(P<0.01);4经多因素回归分析,影响晚发性分裂症回归社会的主要因素有6个,即发病年龄、首次住院疗效、起病形式、维持服药时间、病程和家庭社会支持程度(P<0.01)。结论晚发性分裂症患者回归社会的情况较精神分裂症好;发病年龄晚,急性起病,病程短,首次住院疗效好,坚持长期治疗,有充分的家庭社会支持有利于患者回归社会。

Objective To study the related factors impacting the prognosis of late -onset schizophrenia .Methods The subjects with schizophrenia who were in hospitalization from 2006 to 2013 were followed up until December ,2013 .All 62 patients with late-onset schizophrenia （ study group ） and 120 patients with schizophrenia （ control group ） were included .The subjects were evaluated with a self -compiled questionnaire,the Global Assessment Scale（GAS）,Social Disability Screening Schedule （SDSS）and Activity of Daily living Scale（ADL）.The data were analyzed with t -test,the chi -square test and multiple factor regression .Results The study group had better compliance to treatment（χ2 =5.208,P〈0.05）,and lower recurrence rate than the control group （χ2 =4.504,P〈0.05）.The rate of improvement was significantly higher in study group than that in control group （χ2 =9.360,P〈0.05）.The study group had better so-cial function and activity of daily living than the control group （P〈0.01）.Multiple regression analysis showed that the related factors to prognosis of late-onset schizophrenia were onset age ,efficacy of first hospitalization,pattern of onset,therapy time,illness duration and degree of society support（P〈0.01）.Conclusion Late-onset schizophrenia may have better prognosis than schizophrenia ,and the old onset age ,acute onset ,shorter illness duration ,better therapeutic effect in the first hospitalization ,long-term therapy compliance and enough family support are associated with better prognosis .