首发精神分裂症患者不同疾病归因与首次就诊时间、治疗依从性的关系

Relationship between first visit time, compliance and different attribution in first-episode schizophrenic patients

目的 探讨首发精神分裂症患者不同疾病归因与首次就诊时间、治疗依从性的关系.方法 选取2013年3月~2015年3月我院收治的100例首发精神分裂症患者为研究对象,采用本院自制量表调查家属对于患者疾病的归因,依据患者不同疾病归因将患者分为个体素质因素组（27例）、社会心理因素组（65例）、超自然因素组（8例）.患者出院后维持1年的跟踪随访,分析比较不同疾病归因患者的病程、疾病复发情况、治疗依从性及康复治疗效果.结果 个体素质因素组患者病程明显低于社会心理因素组和超自然因素组（P〈0.05）;个体素质因素组和社会心理因素组复发率明显低于超自然因素组（P〈0.05）;个体素质因素组服药依从性和复诊依从性明显高于社会心理因素组和超自然因素组,且社会心理因素组服药依从性和复诊依从性明显优于超自然因素组（P〈0.05）;住院前3组患者的自知力与治疗态度问卷（ITAQ）和社会功能缺陷筛选量表（SDSS）评分差异均无统计学意义（P〉0.05）,1年后个体素质因素组ITAQ评分、SDSS评分明显优于社会心理因素组和超自然因素组,且社会心理因素组上述指标明显优于超自然因素组,差异有统计学意义（P〈0.05）.结论 应针对首发精神分裂症患者家属进行积极的个体化的宣传教育,改善其对疾病的认知以及消极的治疗态度,使家属积极支持患者维持治疗,促进患者康复.

Objective To explore the relationship between first visit time, compliance and differ-ent attribution in first-episode schizophrenic patients.Methods Totals of 100 patients with schizophrenia from March 2013 to March 2015 in Huazhong University of Science and Technology Affiliated Tongji Medical School Mental Health Center were included in this study. All patients were divided into three groups according to the attribution of disease：A group（individual factor, 27 cases）, B group（socio-psychological factor, 65 cas-es） and C group（supernatural factor, 8 cases）. After one-year follow-up after discharge from hospital, course of disease, recurrence, treatment compliance and effects of rehabilitation were compared.Results The course of disease in A group was significantly shorter than that in B and C group（P〈0.05）. The recurrence rate in A and B group was significantly lower than that in C group（P〈0.05）. The drug and return visit compliance in A group was significantly higher than that in B and C group（P〈0.05）. And drug and return visit compliance in B group was signifi-cantly higher than that in C group（P〈0.05）. No significant differences were found on Insight and Treatment Attitudes Questionnaires（ITAQ） scores and Social Disability Screening Schedule（SDSS） scores in three groups before hospi-talization（P〉0.05）. After one year, scores of ITAQ and SDSS in A group were significantly better than that in B and C group, while B group was better than C group（P〈0.05）.Conclusions Active individualized propaganda and education on the family dependents of patients with first-episode schizophrenia can improve their cognition of disease and negative attitude, promote them to support the maintenance treatment and improve rehabilitation.