院内精神康复治疗对长期住院精神分裂症患者的效果研究

Study on the effect of in-hospital mental rehabilitation therapy on long-term inpatients with schizophrenia

目的探讨院内精神康复治疗对长期住院精神分裂症患者的应用效果,为优化长期住院精神分裂症患者的院内管理模式提供指导。方法选取2017年6月1日至2020年6月1日该院精神科收治的精神分裂症住院患者145例为研究对象,根据随机数字表法分为康复组(73例)和对照组(72例)。对照组患者接受常规治疗,康复组患者在常规治疗基础上增加精神康复治疗。于入组时及干预1、3、6月后分别对2组患者的病情进行阳性与阴性症状量表(PANSS)、个人与社会功能量表、自信心量表评估。结果剔除失访病例后,2组患者各70例。在入组时,2组患者PANSS、个人与社会功能量表、自信心量表的评分比较,差异均无统计学意义(P>0.05)。干预后,2组患者PANSS总分随着时间依次下降,均低于入组时,差异均有统计学意义(P<0.01);干预后1、3个月,康复组患者PANSS总分,阳性症状、阴性症状评分均低于对照组,差异均有统计学意义(P<0.05);干预后6个月,康复组患者PANSS总分,阳性症状、阴性症状、一般精神病理评分均低于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者个人与社会功能量表总分、自信心量表总分随着时间依次升高,均高于入组时,差异均有统计学意义(P<0.01);干预后1、3、6个月,康复组患者个人与社会功能量表总分及自信心量表总分均高于对照组,差异均有统计学意义(P<0.05)。结论相对于传统常规治疗,加入精神康复治疗能更有效地改善长期住院精神分裂症患者的阳性症状、阴性症状、一般精神病理症状、个人与社会功能和自尊程度,其优势具有时间积累效应,有利于患者全面康复并回归社会。

Objective To explore the effect of in-hospital mental rehabilitation treatment on long-term inpatients with schizophrenia,and provide guidance for optimizing the in-hospital management mode of long-term inpatients with schizophrenia.Methods A total of 145 inpatients with schizophrenia admitted to the Department of Psychiatry of this hospital from June 1,2017 to June 1,2020 were selected as the research objects.According to the random number table method,they were divided into the rehabilitation group(73 cases)and the control group(72 cases).The control group received routine treatment after enrollment,and the rehabilitation group added mental rehabilitation treatment on the basis of routine treatment.At the time of enrollment,the first month,the third month and the sixth month,the patients in the two groups were assessed with the Positive and Negative Symptom Scale(PANSS),Personal and Social Performance Scale,and the Rosenberg Self-Esteem Scale.Results After excluding the lost follow-up cases,there were 70 patients in each group.At the time of enrollment,there were no significant differences between the rehabilitation group and the control group in the score of PANSS,Personal and Social Performance Scale and the Rosenberg Self-Esteem Scale(P>0.05).After the intervention,the total scores of PANSS in the two groups decreased with time,which was lower than that when they entered the group,and the difference was statistically significant(P<0.01).At the first and third month after intervention,the total PANSS score,positive symptom and negative symptom scores of the rehabilitation group were lower than those of the control group,and the differences were statistically significant(P<0.05).At the sixth month after the intervention,the total PANSS score,positive symptoms,negative symptoms and general psychopathology scores of the rehabilitation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The total scores of the Personal and Social Performance Scale of the rehabilitation group and the control group increased in turn with time,and were higher than the time of enrollment,and the differences were statistically significant(P<0.01).At the first,third and sixth months after the intervention,the total scores of Personal and Social Performance Scale and the Rosenberg Self-Esteem Scale in the rehabilitation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with the traditional management mode,the combination of mental rehabilitation treatment mode can more effectively improve the positive symptoms,negative symptoms,general psychopathological symptoms,personal and social functions,self-esteem of long-term hospitalized schizophrenic patients.Its advantages have a time accumulation effect,which is more beneficial for patients to fully recover and return to society.