主动式社区干预对精神分裂症患者康复效果的影响

Follow-up Study on the Rehabilitation Effect of Assertive Community Treatment for Schizophrenia Patients

目的探讨主动式社区干预对精神分裂症患者康复效果的影响。方法以完成随访的215例社区精神分裂症患者为对象,采用随机数字表法分为干预组(104例)和对照组(111例)。干预组接受主动式社区干预,对照组接受常规社区精神卫生服务,持续干预12个月,再随访12个月。比较两组患者在入组时、6个月、12个月以及24个月时的阳性与阴性症状量表(PANSS)、个人与社会表现量表(PSP)、自尊量表(SES)以及生活满意度指数A量表(LSIA)评分。结果干预方法和时间在PANSS总量表及3个分量表、PSP、SES、LSIA量表评分上存在交互作用(F分别为17.679、15.605、10.874、6.432、45.600、16.228、2.709,P<0.01)。干预方法在PANSS总量表、阴性症状量表评分上的主效应均显著(F分别为5.120、4.952,P<0.05),在PSP、LSIA量表评分上的主效应均显著(F分别为21.948、5.250,P<0.01);时间在PANSS总量表及3个分量表、PSP、SES量表评分上的主效应均显著(F分别为20.642、7.752、7.517、39.783、29.049、20.128,P<0.01),在LSIA量表评分上的主效应显著(F分别为12.984,P<0.05)。结论主动式社区干预能够改善精神分裂症患者的精神症状、个人与社会表现、自尊水平以及生活满意度,且效果具有一定的持续性。

Objective To explore the effect of assertive community treatment on rehabilitation in patients with schizophrenia.Methods A total of 215 registered schizophrenia in community were divided into intervention group(104 cases)and control group(111 cases)by random number table.The intervention group received assertive community treatment,while the control group received routine community mental health services for 12 months,and all patients were followed up for another12 months.The scores of Positive and Negative Symptoms Scale(PANSS),Personal And Social Performance Scale(PSP),Self-esteem Scale(SES)and Life Satisfaction Index A(LSIA)were compared between the two groups at the time of admission,6,12 and 24 months,respectively.Results Intervention method and time had interaction on the scores of PANSS total scale and 3 subscales,PSP,SES,and LSIA scale(F=17.679,15.605,10.874,6.432,45.600,16.228,2.709,P<0.01).The main effect of intervention method on the scores of PANSS total scale,negative symptom Scale were significant(F=5.120,4.952,P<0.05);the main effect of intervention method on the scores of PSP and LSIA scale were significant(F=21.948,5.250,P<0.01);the main effect of time on the scores of PANSS total scale and 3 subscales,PSP,and SES scale were significant(F=20.642,7.752,7.517,39.783,29.049,20.128,P<0.01).The main effect of time on the scores of LSIA scale was significant(F=12.984,P<0.05).Conclusion Assertive community treatment can improve the psychiatric symptoms,personal and social performance,self-esteem and life satisfaction of patients with schizophrenia,and the effect has a certain persistence.