摘要
目的：探讨精神卫生综合康复治疗模式对社区精神分裂症患者的康复作用。方法：从深圳市精神疾病防治网络系统以及同期在医院门诊长期药物维持治疗的精神分裂症患者中各随机抽取200例患者分为社区组（药物治疗联合精神卫生综合康复治疗,最终完成122例）和门诊组（仅给予药物治疗,最终完成124例）;采用阳性和阴性症状量表（PANSS）、锥体外系副反应量表（RESES）、威斯康星卡片分类测验（WCST）及世界卫生组织残疾评定量表第2版中文版（WHO-DAS-Ⅱ）分别在基线时和康复治疗1年后进行评估并比较两组精神症状、不良反应、认知功能及社会功能的变化。结果：两组PANSS、RESES、WCST及WHO-DAS-Ⅱ评分基线时差异无统计学意义（t=0.14～1.34,P〉0.05）;康复治疗1年后社区组阴性症状、RESES、WHO-DAS-Ⅱ中与他人相处及社会参与较门诊组显著改善,组间主效应明显（F=5.030,F=15.869,F=7.822,F=9.713;P〈0.05或P〈0.01）。社区组复发率、再入院率、肇事肇祸率、经济负担方面较门诊组显著下降（χ^2=5.35,χ^2=4.34,χ^2=3.86,t=5.84;P〈0.05或P〈0.01）。结论：综合康复治疗联合药物治疗在改善患者精神症状、减轻不良反应、降低复发率、提高认知功能和社会功能方面的疗效优于单纯药物治疗。
Objective：To explore the effect of mental health rehabilitation treatment model for schizophrenia in community.Method：Respectively,200 patients with schizophrenia selected randomly as community group（ had received medication and mental health rehabilitation care,finally 122 patients completed test） and outpatient group（ had received medication only,finally 124 patients completed test） from the database of mental illness prevetion network of Shenzhen and the hospital outpatients with drug maintence therapy in the same period.We evaluated the psychiatric symptoms,cognitive function and social function of both two group patients with positive and negative symptoms scale（ PANSS）,extrapyramidal side effects scale（ RESES）,Wisconsin card sorting test（ WCST） and world health organization disability rating scale Chinese version 2th edition（ WHO-DAS-Ⅱ） at the baseline and after 12 months therapy and compared the difference of psychiatric symptoms,side effects,cognitive function and social function between the two groups.Results：At the baseline,there were no significant difference found between the two groups on PANSS,RESES,WCST and WHO-DAS-Ⅱ scores（ t =0.14 ～ 1.34,P〈0.05）.After 12 months therapy,the increase of negative symptom,RESES and WHO-DAS-Ⅱfactor getting along with people and social participation in society in community group more than that in outpatient group,the main effect of the group was obviously（ F = 5.030,F = 15.869,F = 7.822,F = 9.713;P〈0.05 or P〈0.01）.The decrease of scores on relapse rate,readmission rate,making / causing trouble rate and financial burden of community group were more than that of the outpatient group（ χ^2= 5.35,χ^2= 4.34,χ^2= 3.86,t =5.84;P〈0.05 or P〈0.01）.Conclusion：Mental health comprehensive rehabilitation therapy can help reducing residual psychiatric symptoms,side effects and relapse rate,and improving cognitive function and social function.The effect of mental health comprehensive rehabilitation therapy combing with medication is better than that of medication alone.
出处
《临床精神医学杂志》
2015年第6期387-390,共4页
Journal of Clinical Psychiatry
关键词
精神分裂症
综合康复治疗
schizophrenia
comprehensive rehabilitation therapy
