自杀风险量化评估策略下动态干预对精神分裂症患者危险行为的影响

Effect of dynamic intervention on risk behaviors of patients with schizophrenia using the strategy of quantitative suicide risk assessment

目的探讨自杀风险量化评估策略下动态干预对精神分裂症患者危险行为的影响。方法152例精神分裂症患者,按随机数字表法随机纳入对照组和联合组,各76例。对照组采用常规护理,观察组采用自杀风险量化评估策略下动态干预,2组均护理至出院并随访6个月。比较2组肇事肇祸风险及社会功能缺陷、认知功能及精神状况、自杀行为发生率及自杀致死率。结果干预前、干预后1个月、干预后6个月,2组肇事肇祸风险分级、社会功能缺陷筛选量表(SDSS)评分,呈降低趋势,且联合组低于对照组(P<0.05)。干预后1个月,2组蒙特利尔认知评估表(MoCA)评分较干预前均升高,且联合组高于对照组,阳性与阴性症状量表(PANSS)评分较干预前均降低,且联合组低于对照组(P<0.05)。随访期间,联合组自杀行为发生率低于对照组(3%与12%,P<0.05),2组自杀致死率比较,差异无统计学意义(0与1%,P>0.05)。结论自杀风险量化评估策略下动态干预可降低精神分裂症患者危险行为,提高其认知功能、精神状态及社会功能,进而降低自杀行为发生率。

Objective To investigate the effect of dynamic intervention on risk behaviors of schizophrenic patients using the strategy of quantitative suicide risk assessment.Methods A total of 152 patients with schizophrenia were randomly included into the control group and the study group(n=76 each).The control group was nursed with routine care,while the study group was nursed with dynamic intervention using the strategy of quantitative suicide risk assessment.The both groups were on nursing care until discharge and were then followed up for 6 months.Betweengroup comparison was performed on the risk of violent offending,impaired social functioning,cognitive functioning and mental status,incidence of suicidal behavior and the suiciderelated mortality.Results Before and at one and six months after the intervention,the risk classification of violent offending and SDSS score in either group showed a de-creasing trend,and were lower in the study group than those in the control group(P<0.05).At one month after inter-vention,the MoCA score in either group was higher than baseline,and was higher in the study group than that in the control group;the PANSS score in either group was lower than baseline,and was lower in the study group than that in the control group(P<0.05).During the follow-up,the incidence of suicidal behavior was lower in the study group than that in the control group(3%vs 12%,P<0.05).There was no statistical difference in the suiciderelated mortality be-tween the two groups(0 vs 1%,P>0.05).Conclusion Dynamic intervention using the strategy of quantitative suicide risk assessment can reduce the risk behaviors in patients with schizophrenia,improve their cognitive functioning,men-tal status and social functioning,and thereby reducing the incidence of suicidal behavior.