精神分裂症首次发病患者未治期的影响因素分析

Duration of untreated psychosis and its correlates in first-episode schizophrenia

目的：探讨首发精神分裂症患者未治期（ DUP）的影响因素。方法：采用一般资料调查表、阳性与阴性症状量表（ PANSS）、诺丁汉起病症状量表（ NOS）以及疾病家庭负担量表（ FBS）对206例首次发病精神分裂症患者的疾病严重程度、起病形式以及因疾病给家庭带来的负担进行评估。结果：首发精神分裂症患者DUP的中位数为6（2，12）个月，其中男性5（1，12）个月，女性7（2，12）个月，男女比率差异无统计学意义（P〉0.05）。将患者分为短DUP组（DUP≤6个月）112例和长DUP组（DUP〉6个月）94例比较结果显示，不同DUP组的起病形式（χ2=61.99，P=0.000）、家属对患者的关心程度（t=4.09，P=0.000）、疾病对家庭娱乐活动的影响（t=-2.22，P=0.03）以及疾病对家庭成员心理健康的影响（t=-2.53，P=0.01）两组间存在统计学意义。Logistic 回归分析发现，起病形式（ OR =11.46，95%CI =5.70∽23.04）是DUP的危险因素；家属对患者的关心程度（OR=0.73，95%CI=0.60∽0.90）是DUP的保护性因素。结论：影响首发精神分裂症患者DUP的因素是多方面的，但起病形式及家属对患者的关心程度是主要因素。

Objective：To investigate the factors of duration of untreated psychosis（ DUP）in first-episode schizophrenias. Method：We adopted self-made questionnaire,positive and negative syndrome scale（ PAN-SS）,family burden scale of disease（FBS）and Nottingham onset schedule（NOS）to assess 206 patients who were diagnosed with first-episode schizophrenia. Resuits：The median（ lower quartile,upper quartile）of DUP in first-episode schizophrenia patients was 6 month（2 month,12 month）and the DUP of men was 5 month（1 month,12 month）,women was 7 month（2 month,12 month）. There′s no statistical significance of DUP in sex composition（P〉0. 05）. The comparison of the short DUP group（DUP≤6 month,112 patients）and long DUP group（DUP〉6 monrh,94 patients）showed that there was significant difference of mode of onset（χ2 =61. 99, P=0. 000）,degree of the care of family members to the patients（t=4. 09,P=0. 000）,the influence of disease on family entertainment（t= -2. 22,P=0. 03）,the influence of disease on family members′mental health（t=-2. 53,P=0. 01）between the short DUP group and long DUP group. Logistic regression analysis found that mode of onset（OR=11. 46,95%CI=5. 70∽23. 04）was risk factor of DUP and degree of care of family mem-bers to the patients（OR=0. 73,95%CI=0. 60∽0. 90）was protective factor of DUP. Conciusion：The influ-encing factors of DUP are various,the degree of the care of family members to the patients and the mode of onset may have major influences on the DUP.