社区精神分裂症患者应用重返社会程式训练的一年随访研究

Improvements of symptom and social function in outpatients with schizophrenia receiving community re-entry program:a 1-year follow-up study

目的 探讨重返社会技能训练程式对于社区精神分裂症患者康复的作用。方法 将10 0例非急性期的社区精神分裂症患者随机分为技能训练组 (以下简称训练组 ;5 0例 ,其中脱落 5例 )和对照组 (5 0例 ,其中脱落 2例 )。在药物治疗的同时 ,对训练组进行重返社会技能训练 ,对照组接受传统精神康复干预 ,对两组患者随访 1年。采用阳性和阴性症状量表 (PANSS)和MorningSide康复状态量表 (MRSS) ,在干预前、随访第 1,3,6 ,9,12个月时对患者进行评估 ;同时监测病情复发率、(再 )住院率、(再 )就业率。结果 (1)入组时与随访末次评分减分值的比较 ,训练组PANSS总分 [(6 80±11 30 )分 ]、阳性量表 [(0 5 1± 3 36 )分 ]、阴性量表 [(3 14± 5 2 7)分 ]、一般精神病理量表 [(3 14±5 11)分 ]和MRSS总分 [(13 92± 2 1 0 8)分 ]均优于对照组 [分别为 (- 4 33± 18 35 )分、(- 2 93± 7 16 )分、(- 1 2 3± 7 2 7)分、(- 0 16± 7 97)分和 (- 10 0 9± 30 93)分 ],P <0 0 5～ 0 0 1;(2 )训练组的病情复发率 (2 0 % )和 (再 )住院率 (2 % )低于对照组 (分别为 4 0 %和 19% ;P <0 0 5 ) ;(3)训练组的 (再 )就业率(5 1% )高于对照组 (2 3% ;P <0 0 1)。结论 在药物治疗的基础上 ,重返社会程式可以有效地帮?

Objective The study was to examine the effects of community re-entry program on relieving the symptoms and improving the social functions in schizophrenic outpatients. Methods A total of 100 outpatients with schizophrenia was randomly assigned into two groups,the patients in study group were given scheduled skills training course,the others were given traditional rehabilitation training as control. All the subjects were followed up for one year,and assessed with the Positive and Negative Syndrome Scale (PANSS) and Morningside Rehabilitation Status Scale (MRSS) before the study and at the 1st,3rd,6th,9th and 12th month,respectively. Results Ninety-three subjects completed the 1-year follow-up. According to the reduction scores of PANSS,positive,negative,general psychopathology subscale and MRSS,the study group demonstrated better improvement than the control group (6.80±11.30 vs. -4.33±18.35,0.51±3.36 vs. -2.93±7.16 ,3.14±5.27 vs. -1.23±7.27,3.14±5.11 vs. -0.16±7.97,13.92±21.08 vs. -10.09±30.93,respectively; P<0.05-0.01). The rates of relapse and rehospitalization were significantly lower (20% vs. 40%,2% vs. 19%; P<0.05), while the re-employment rate significantly higher in study group (51% vs. 23%, P<0.01) than that in control group. Conclusion Combing with pharmacotherapy,the community re-entry program is helpful in relieving symptoms and improving social function in outpatients with schizophrenia.