精神分裂症患者出院后2年的复发情况调查

A investigation of relapse in patients with schizophrenia after 2 years of discharging

目的：调查精神分裂症患者出院后2年的服药依从性和复发情况以及复发的相关影响因素。方法：选取出院的精神分裂症患者371例,自制调查问卷,回顾性调查出院后第1年及第2年时的复发率、服药认识、依从性、就诊及工作/学习情况;使用Logistic回归分析复发的相关影响因素。结果：患者出院后第1年及第2年复发率分别为32.9%（122例）和40.2%（72例）。出院后第1年复发组与未复发组在对服药的认识、依从性、复诊频率及坚持正常工作/学习比较差异无统计学意义（P〉0.05）;第2年复发组对服药的认识（χ2=17.554）、依从性（χ2=62.514）、复诊频率（χ2=4.131）及坚持正常工作/学习（χ2=9.806）方面均明显差于未复发组（P〈0.05或P〈0.001）。Logistic回归分析显示,第1年及第2年对服药认识积极、服药依从性好及能坚持正常工作/学习的患者复发风险更低（OR=0.152~0.376,P〈0.05或P〈0.01）;而第1年的依从性、服药认识与第2年复发无相关。结论：精神分裂症患者出院后对服药认识积极、依从性好、定期复诊及能坚持正常工作/学习可有效降低复发的风险。

Objective： To explore the factors related to the relapse through studying the medication compliance and relapse in the schizophrenia patients after 2 years of discharge. Method： Three hundred and seventy-one schizophrenic patients discharged were included in the study,and then the investigation into the state of illness,compliance,the opinions on taking medicines,and relapse rate after discharge for a period of 1 year and2 years was accomplished through self-prepared questionnaires. The influencing factors of relapse was analysed by Logistic regression analysis. Results： The relapse rate in the schizophrenic patients after 1 year from discharging was 32. 9%（ 122 examples） and the 2 year was 40. 2%（ 72 examples）. No significant difference was found in the opinions on taking medicines,adherence,frequency of return visit and work / study ability in the first year between the two groups. Compare to those not relapse group,the relapse group was found worse significantly in the opinions on taking medicines（ χ2= 17. 554）,adherence（ χ2= 62. 514）,frequency of return visit（ χ2=4. 131） and work / study（ χ2= 9. 806）,the difference was significant（ P〈 0. 05 or P 〈0. 001）. Logistic regression analysis indicated that patients with positive opinions on taking medicines,good adherence and work / study ability in the first and second year are found with lower risk of relapse（ OR = 0. 152 ~ 0. 376,P〈 0. 05 or P〈 0. 01）,but the attitude and adherence to medication in the first year had no relation to the relapse in the second year. Conclusion： Active attitude to medication,good medication adherence and sticking to work / study can effectively reduce the risk of relapse for patients with schizophrenia after discharge.