社区精神康复对精神分裂症患者精神病性症状和社会功能的影响

Impact of Community Psychotherapy on Schizophrenia Symptoms and Social Performance of Patients

目的了解社区精神康复对精神分裂症患者精神病性症状和社会功能的影响。方法选择出院随访的康复期精神分裂症患者101例为研究对象,随机分为干预组和对照组,两组患者均自愿参加开放兴趣小组,每次活动均有1个确定主题。干预组在此基础上采用个案管理和团体康复训练等社区精神康复形式。两组均随访6月,且采用阴性和阳性症状量表(The Positive and Negative Syndrome Scale,PANSS)评估患者的精神症状,个体与社会功能量表(Personaland Social Performancescale,PSP)评定患者的社会功能,比较两组精神病性症状及社会功能改善情况。结果社区精神康复6月后,两组在阳性症状分、阴性症状分、一般病理分、PANSS总分和PSP总分的改善方面比较差异有统计学意义(P<0.05),干预组优于对照组。PSP改善程度与精神病性症状改善呈正相关,特别是阴性症状改善越明显,患者的PSP能力越好。结论系统的社区精神康复训练可以改善精神病性症状,特别是阴性症状,提高社会功能;且参加精神康复训练时间越长,效果越明显。

Objective Investigating the impact of community psychotherapy on Schizophrenia symptoms and social performance of schizophrenia patients. Methods Selecting 101 post-discharge follow up schizophrenia patients in recovery as the subjects of the study,randomly assigning them into experimental group and control group. Patients from both groups have consent of joining the open interest groups,and every group activity has a set theme. On this basis,case management and psychotherapy like group recovery training etc are applied to the experimental group. A six month follow up session was carried out to both groups.The Positive and Negative Syndrome Scale（ PANSS） was applied to assess the syndromes of patients,and Personal Social Performance（ PSP） was used to assess the social performance of patients. The recovery in terms of syndrome and social performance of patients in both groups is compared. Results After six months of community psychotherapy,comparison the scale of positive syndrome,negative syndrome,general pathology,PANSS and PSP indicate statistical significance（ P 0. 05）,which means experimental group show better results than control group. PSP recovery show positive correlation with the recovery of pathology syndromes,and significant recovery of negative syndromes results in better PSP ability of patients. Conclusion Systematic community recovery training shows effects on pathology symptoms,especially negative symptoms,and raise social performance. Longer participation in recovery training can lead to more significant results.