精神分裂症慢性化相关因素研究

Factors related to chronic schizophrenia

目的探讨精神分裂症慢性化的相关因素。方法收集2012年5月1日~2013年12月31日我院慢性精神分裂症患者及首发精神分裂症患者共400例,分为慢性组213例（慢性精神分裂症患者）与非慢性组187例（首发精神精神分裂症患者）。按照服用的药物分为四组,喹硫平组113例,利培酮组105例,奥氮平组131例,氯丙嗪组51例。比较两组患者的一般资料、治疗前后PANSS总分、四组不同治疗药物组治疗前后PANSS总分及疗效、复发与各项指标的相关性。结果治疗后2个月、6个月、12个月非慢性组PANSS总分与慢性组比较均明显较低（P〈0.05）。治疗12个月后喹硫平组、利培酮组、奥氮平组、氯丙嗪组PANSS总分均明显低于治疗前（P〈0.05）。婚姻状况、发病年龄、持续用药时间、家庭支持情况、家庭经济条件与PANSS减分率呈明显正相关,病程长短、发病诱因、起病形式与PANSS减分率呈明显负相关;持续用药时间与疾病复发情况呈显著负相关（P〈0.05）。结论病程长、起病形式缓慢、发病年龄小、无明显发病诱因、持续用药时间短、家庭支持少、家庭经济状况不好、婚姻情况不稳定精神分裂症患者易发展为＂慢性化＂。此次研究为探索建立一种阻断或延缓精神分裂症慢性化进展的社会-医学-心理支持模式提供了依据。

Objective To investigate the relevant factors of chronic mental disorders classification. Methods All 400 cases of first-episode schizophrenia patients and hospital patients with chronic schizophrenia were selected from May1, 2012 to December 31,2013,213 cases in chronic group（patients with chronic schizophrenia）, 187 cases in non-chronic group（non-chronic mental patients with schizophrenia）. In accordance with medication all of them were divided into four groups, 113 cases in quetiapine group, 105 cases in risperidone group, 131 cases in olanzapine group, 51 cases in chlorpromazine group. General information, PANSS total score of two groups before and after treatment, PANSS total score of four different therapeutic groups before and after treatment, the relevance of efficacy, recurrence and the indicators were compared. Results PANSS total score of non-chronic group after treatment 2 months, 6 months, 12 months were significantly lower than chronic group（P〈0.05）. PANSS total scores of quetiapine group, risperidone group,olanzapine group, chlorpromazine group 12 months after treatment were significantly lower than before treatment（P〈0.05）.Marital status, age of onset, continuous medication time, family support, the family economic conditions and PANSS score reduction rate was positively correlated, duration, predisposing factors, onset form and PANSS score reduction rate was negatively correlated; continued drug use time and disease recurrence was significantly negatively correlated（P〈0.05）. Conclusion Longer duration, slow onset form, younger onset, no obvious predisposing factors,short-duration treatment time, less family support, family economic situation is not good, marital instability in patients prone to develop schizophrenia as ＂chronic.＂ The study is to explore the establishment of a block or delay the progression of chronic schizophrenic society-medicine-psychological support model provides a basis.