重性精神疾病管理治疗模式下首发精神分裂症患者复诊情况对远期预后的影响

Influence of follow-up visit on long-term prognosis of first-episode schizophrenic patients under severe mental illness management and treatment mode

目的:探讨重性精神疾病管理治疗模式下首发精神分裂症患者复诊情况对其远期预后的影响。方法:抽取重性精神疾病管理治疗模式下首发精神分裂症患者115例,其中复诊规律组88例,停药组(症状消除)5例,复诊不规律组22例,运用阳性与阴性症状量表(PANSS)、自知力与治疗态度问卷(ITAQ)、个人和社会功能评定量表(PSP)、社会支持评定量表(SSRS)、精神分裂症患者生命质量量表(SQLS)评估3组患者远期预后并比较。结果:复诊规律组患者占76.52%,复诊不规律组患者占19.13%,停药组(症状消除)占4.35%,PANSS评分3组差异有统计学意义(F=6.371,P<0.01),复诊规律组(t=3.594,P<0.001)和停药组(症状消除)(t=2.113,P<0.05)明显低于复诊不规律组;ITAQ评分3组差异有统计学意义(F=10.981,P<0.001),复诊规律组明显高于复诊不规律组(t=-4.654,P<0.001);PSP评分3组差异有统计学意义(F=9.271,P<0.001),复诊规律组(t=-3.949,P<0.001)和停药组(症状消除)(t=-2.859,P<0.01)明显高于复诊不规律组;SSRS评分3组差异有统计学意义(F=3.535,P<0.05),复诊规律组明显高于复诊不规律组(t=-2.550,P<0.05);SQLS评分3组差异无统计学意义(F=1.840,P>0.05)。结论:重性精神疾病管理治疗模式下首发精神分裂症患者治疗依从性明显提高,远期预后综合考察,复诊规律组在精神症状改善,自知力提高,社会功能以及社会支持方面都明显好于复诊不规律组,而生活质量上与复诊不规律组同一水平。

Objective:To explore the influence of the follow-up visit on the long-term prognosis of the first-episode schizophrenic patients under the management and treatment mode of severe mental illness.Methods:A total of 115 first-episode schizophrenic patients were randomly selected,including 88 patients in regular follow-up group,5 patients in drug withdrawal group(symptom elimination)and 22 patients in irregular follow-up group.Positive And Negative Symptom Scale(PANSS),Insight and Treatment Attitude Questionnaire(ITAQ),Personal and Social Performance scale(PSP),Social Support Rating Scale(SSRS)and Schizophrenic Quality of Life Scale(SQLS)were used to evaluate and compare the long-term prognosis.Results:There were 76.52%patients in regular follow-up visit group,19.13%patients in irregular follow-up visit group and 4.35%patients in drug withdrawal group(symptom elimination).The difference of PANSS score among three groups was significant(F=6.371,P<0.01),and the PANSS scores in the regular follow-up group(t=3.594,P<0.001)and the group with stopping drugs(t=2.113,P<0.05)were lower than that of the irregular group.The difference of ITAQ score was significant(F=10.981,P<0.001)among three groups,and that of the regular follow-up group was higher than that of the irregular follow-up group(t=-4.654,P<0.001).The difference of PSP score among the three groups was significant(F=9.271,P<0.001),and that of the regular follow-up group(t=-3.949,P<0.001)and the drug withdrawal group(t=-2.859,P<0.01)were higher than that of the irregular group.There was difference in SSRS score among the three groups(F=3.535,P<0.05),and that of the regular group was higher than that of the irregular group(t=-2.550,P<0.05).There was no statistical significance among the three groups of SQLS score(P>0.05).Conclusion:After comprehensive investigation of long-term prognosis,the improvement of mental symptoms,insight,social function and social supports in regular follow-up visit group are significantly better than those in irregular follow-up group,but the quality of life is the same as that in irregular follow-up group.