摘要
目的 探讨精神科医师开展个别化家庭干预的特点、方式和可行性及其对精神分裂症的康复作用。方法 将 10 0例痊愈出院的精神分裂症患者随机分为干预组和对照组各 5 0例。患者出院后获邀定期接受门诊复诊或随访。尽量维持抗精神药种类和剂量不变 ,随访研究持续三年。对干预组施以个别化家庭干预 (个别家庭心理教育辅与认知行为治疗 ) ,对对照组仅施以一般支持性心理治疗。用阳性症状和阴性症状量表 (PANSS)、社会功能缺陷筛选表 (SDSS)、自制患者服药依从性量表和复发率等进行评估。结果 随访首次与末次评分差值的比较 ,干预组的患者服药依从性评分 (15 .3± 6 .3)分、PANSS总分 (5 .2 3± 2 .36 )分、SDSS分 (4.1± 2 .7)分均显著优于对照组分别为 (35 .6± 8.3)分、(- 11.34± 4 .7)分和 (- 4 .2 5± 1.4 )分 ,均P <0 .0 1。⑵干预组的复发率 (10 % )、再住院率 (6 % )和再就业率 (6 0 % )皆优于对照组 (分别为 4 3%、2 1%和 38% ,P <0 .0 1)。结论 精神科医师对痊愈出院的精神分裂症患者随访介入个别化家庭干预可行性较强 ,对控制患者的病情 ,提高服药依从性、社会功能和再就业率 。
Objective The purpose of this study was to investigate the characteristic, feasibility and rihabilitive efficacy of individual family intervention for schizophrenics which get involved by psychiatrists. Methods 100 patients with schizophrenia which had recovered and whole being discharged from hospital were randomly divided into the intervention group and control group. The followup study was carried out after their discharge from hospital until three years. Both groups received the antipsychotics, but individual family intervention(individual family psychosocial education and cognitive behavioral therapy)were only given to the intervention group, and general supportive psychotherapy were given to control group. All subjects were evaluated with the Positive and Negative Syndrome Scale(PANSS), social Disability Screening Schedule(SDSS)?self-complied drug treatment compliance rating scale and relapse,reeployment rate,rehospitalization rate. Results 95 subjects completed the study. The intervention group demonstrated better improvement in the total score of PANSS and SDSS than the control group(5.23±2.36 vs. -11.34±4.7, 4.1±2.7 vs. -4.25±1.4, P<0.01),and the total score of the drug treatment compliancerating scale was higher in intervention group than that in control group(15.3±6.3 vs. 35.6±8.3, P<0.01). the clinical outcome in intervention group demonstrated significantly superior to the control group on overall improvement according to the relapse rate(10% vs. 43%), rehospitalization rate(6% vs. 21%)and reemployment rate(60% vs. 38%),P<0.01. Conclusion The effect of individual family intervention which get involved by psychiatrists after those schizophrenia patients had get recovered and they were discharged from hospital for schizophrenics not only reduce their disabilities and increase the reemployment rate,but relapse and rehospitalization.
出处
《中国行为医学科学》
CSCD
2002年第4期394-396,共3页
Chinese Journal of Behavioral Medical Science
关键词
精神分裂症
个别化家庭干预
康复
随访研究
Schizophrenia
Individual family intervention
Rehabilition
Follow studies
