积极性社区干预对精神分裂症患者疗效及家庭经济负担的影响

Effects of Assertive Community Intervention on Patients with Schizophrenia and Their Family Economic Burden

[目的]评估积极性社区干预对精神分裂症患者疗效及其家庭经济的影响。[方法]120例符合入组标准的社区慢性精神分裂症患者,随机分为研究组和对照组,研究组予积极性社区干预,对照组提供常规的社区精神卫生服务,随访观察1年。分别于干预开始前、干预1年末进行"阳性与阴性症状量表(PANSS)""生活质量综合评定问卷-74(成人用)(GQOLI-74)""社会功能缺陷筛选量表(SDSS)"评定,并采用自制疾病经济花费调查表比较治疗1年期间两组患者的医疗费用和其他经济损失情况。[结果]干预1年末,研究组PANSS、GQOLI-74、SDSS评分与对照组比较,差异有统计学意义(t=5.036,P=0.000;t=3.309,P=0.001;t=2.408,P=0.011)。研究组患者复发1例(1.7%),对照组复发11例(18.3%),两组差异有统计学意义(χ2=7.50,P=0.01)。研究组1年中因精神疾病造成的家庭经济损失低于对照组,差异具有统计学意义(Z=2.517,P=0.012)。[结论]积极性社区干预能有效改善慢性精神分裂症患者的临床症状,提高生活质量和社会功能,减轻患者家庭经济负担。

[ Objoctive ] To evaluate the effects of assertive community intervention on patients with schizophrenia and family economic burden. [ Methods ] Patients （n=120） with chronic schizophrenia and meeting study recruitment requirements were randomly assigned to a study group （with assertive community intervention） and a control group （with regular community mental health service）. All the patients were followed up for one year. Positive and Negative Syndrome Scale （PANSS）, Generic Quality of Life Inventory （GQOLI-74）, and Social Disability Screening Schedule （SDSS） were assessed before and after the one- year intervention. Self-administered form on disease burden was also used to compare the medical expense and other economic loss of the two groups. [ Results ] At the end of the one-year intervention, there were statistical differences in the score averages of PANSS, GQOLI-74, and SDSS between the intervention group and the control group （t=-5.036, P=0.000; t=3.309, P=0.001; t=2.408, P=0.011）. One case relapsed in the intervention group （1.7%）, whereas 11 cases did in the control group （18.3%） （Z2=7.50, P=0.01）. The economic loss related to schizophrenia in the intervention group was lower than that in the control group （Z=2.517, P=0.012）. [ Conclusion ] Assertive community intervention shows significant improvement in clinical symptoms, quality of life, and social function and reducing the family economic burden of patients with schizophrenia.