精神障碍患者社会功能缺损评定量表的信效度分析

Objective To test the reliability and validity of the rating scale of social function deficit due to mental disorders (SSFD-MD). Methods 1003 cases with mental disability evaluation were tested by SSFDMD. At sametime, 100 cases of 1003 cases were test-retested and back to back tested by two examiners. 300 cases of 1003 cases also were tested by social disability screening schedule( SDSS),scale of social function for psychosis inpatients(SSPI),global assessment function(GAF) ,the brief psychiatric rating scale(BPRS) ,WH0 disability assessment scale Ⅱ (WHO-DASⅡ ), adult rating scale of mentally disabled ( ARSMD) and rating scale for extrapyramidal side effects (RSESE). Results ①The Cronbach's α coefficients of the total score and all dimensions of SSFD-MD were more than 0.90. The test-retest reliability ranged from 0.67～0. 83 ,and the scorer reliability were 0. 87～0.97. ②The correlations between item scores ranged from 0.46 ～0.74(P＜0.01). The correlations between the factor scores and the total scores ranged from 0.73～0.87(P＜0.01). To extract five full-scale principal components after orthogonal rotation to maximize variance,the cumulative total variance explained was 82.25%.There were highly correlations between SSFD-MD and SDSS.SSPI and GAF,respectively ( r = 0. 71,0.72 and 0. 78). There were moderate correlations between SSFD-MD and BPRS WHO-DAS II ARSMD,respectively(0.62,0. 50 and 0.46). There was a low correlations between SSFD-MD and RSESE ( r = 0.22) ,but all correlations were significant(P＜0.01). Conclusion SSFD-MD has acceptable psychometrics properties on reliability and validity.     

中文版自我表露预期结果量表的修订

目的 编制适合中国人使用的自我表露预期结果量表,并进行信效度检验.方法 在研究国外相关问卷和预备测试的基础上,分别选取了天津市不同年级、不同专业的在校大学生进行问卷测试,验证中文版的信、效度.结果 量表的内部一致性信度分别为0.741和0.742.量表的重测信度分别为0.753和0.766.预期风险维度与自我隐藏量表总分之间存在显著的正相关(r=0.6554,P<0.01);预期效用维度与自我隐藏量表总分之间存在显著的负相关(r=-0.6752,P<0.01).验证性因素分析验证了2维度模型.结论 修订的自我表露预期结果量表具有良好的信度和效度,可以满足我国有关研究和应用的需要.

Abstract：

Objective To revise the disclosure expectations scale and to exam its reliability and validity.Methods Based on researching foreign related questionnaire and preparing test,university students from different grades and majors were chosen as subjects to exam the reliability and validity of questionnaire of stigma for seeking professional psychological help.Results The Cronbach's alpha coefficients of the questionnaire were 0.7412 and 0.7423.The retest reliability of the questionnaire were 0.7527 and 0.7662.There was a significantly positive correlation between risk factor and the self-concealment scale(r=0.6554,P<0.01).There was a significantly negative correlation between benefit factor and the self-concealment scale(r=-0.6752,P<0.01).Confirmatory factor analysis verified the 2 dimensional models.Conclusion The revised disclosure expectations scale has good reliability and validity,and Can satisfy the domestic relevant research and applied demand.     

Thirty Cases of Obsession Treated by Point-Stimulation and with Small Dose of Chlorimipramine

Objective: To investigate the clinical therapeutic effects of point-stimulation for obsession. Methods: Sixty cases of obsession were divided into two groups: a control group of 30 cases treated with chlorimipramine (Ch1), and a treatment group of 30 cases treated by point-stimulation (PS) plus chlorimipramine (PS Chl). The therapeutic effects and side-effect were evaluated according to the criteria set in Yale-Brown Obsession Scale (Y-BOCS), Hamilton's depression scale (HAMD), brief psychiatric rating scale (BPRS) and treatment emergent symptom scale (TESS). Results: The cure rate and markedly effective rate were respectively 26.7% and 56.6% in the control group, and 43.3% and 50% in the treatment group, suggesting that the therapeutic effect in the treatment group was better than that in the control group. The incidence of adverse side-effects was 73.33% in the control group and 46.67% in the treatment group, with a significant difference between the two groups (P<0.05). Conclusion: Point-stimulation plus small dose of chlorimipramine was superior to the simple chlorimipramine treatment, indicating that the combined method was more effective and safe for obsession with less side effects.     

中文版精神分裂症认知功能评定量表信度与效度研究

目的 对精神分裂症认知功能评测量表(Schizophrenia Cognition Rating Scale,SCoRS)中文版的信度和效度进行研究.方法 对112例精神分裂症患者作SCoRS、精神分裂症认知功能简明成套测评量表(BACS)、个人和社会功能量表(PSP)评测.使用主成分分析法、信度分析法及相关分析对所得数据进行统计分析.结果 信度分析显示,Cronbach α=0.963,条目经标准化后Cronbach α=0.964,HotellingT2=248.948,F=10.767,P=0.000,去掉任意一条对信度系数的影响均小于0.01.主成分分析:KMO统计量为0.864.因子分析显示:因子1包括条目1,3,4,5,6,7,8,9,11,反映神经认知功能状态;因子2包括条目10,17,18,19,20,反映社会认知功能状态;因子3包括条目2,12,13,14,15,16,主要反映日常生活功能状态.SCoRS自评分、知情者评分、评定者评分总分与PSP总分及其社会中有益的活动、个人和社会关系、自我照料等因子分均呈中度相关.SCoRS因子分中,除自评分因子3与PSP总分无显著相关性外,余各项之间均存中度显著相关性.SCoRS各评分与扰乱及攻击行为之间不具有显著相关性.SCoRS自评分、知情者评分、评定者评分总分与PSP总分及因子分与BACS复合分及各分测验分之间均呈显著相关性.结论 SCoRS(中文版)是一种良好的认知功能评测工具,适用于汉语地区精神分裂症患者认知功能损害评测.

Abstract：

Objective To investigate the reliability and validity of the Chinese version of the schizophrenia cognition rating scale ( SCoRS) . Methods 112 cases of schizophrenia or schizophreniform disorder inpatients were recruited and assessed using the SCoRS( Chinese version) ,the brief assessment of cognition in schizophrenia (BACS) and personal and social performance scale(PSP). The principle component analysis,reliability analysis and correlation analysis were used to analyze the data. Results Standardized Cronbach α = 0.964. All the 20 i-tems were significantly correlated. Except item 1 ,9,18,19 ( r=0. 830,0. 890,0. 871,0. 890) ,the interrater correlation coefficiency (ICC) of the rest of the items was over 0.9. The ICC of global rating scores between two raters was 0. 921. Factor analysis procedure identified three factors. Factor 1 reflected the neurocognitive state; factor 2 reflected the social cognitive state;and factor 3 mainly reflected the daily life function. The SCoRS rating scores were significantly correlated with the BACS and PSP scores. Conclusion The validity and reliability of SCoRS are acceptable. SCoRS is a useful tool for assessing the deficits of the cognitive function for Chinese schizophrenia patients.     

核心自我评价量表在企业员工和大学生中的信效度研究

目的 在企业员工和大学生中修订核心自我评价量表(Core Self-Evaluation Scale,CSES),考察其信度和效度.方法 对原量表进行翻译和回译;对400名企业员工和272名大学生2个样本进行测试,检验中文版核心自我评价量表的信度与效度.结果 量表在企业员工和大学生2个群体中,内在一致性信度分别为0.71和0.81,重测信度分别为0.81和0.84;验证性因素分析显示在两群体中单因素模型均拟合较好,且在两个群体中都具有良好的会聚效度和增益效度.结论 表明核心自我评价量表在企业员工和大学生两个群体中具有较好的信、效度,可以在实际研究中作为测量核心自我评价概念的工具.

Abstract：

Objective To revise Core Self-Evaluation Scale (CSES) and examine its reliability and validity in employees and undergraduates in China. Methods The adaptation of the scale was gotten by way of translation and back-translation. 400 employees and 272 undergraduates were tested by questionnaires, and their data were used to evaluate reliability and validity of the scale. Results In employees and undergraduates, the Cronbach' s coefficient of the CSES was respectively 0.71,0.81, and the test-retest reliability was respectively 0.81,0.84. The results of confirmatory factor analysis showed that the single factor model was more fit for the revised CSES. The scale had good convergent validity and incremental validity in the samples. Conclusion The CSES has good reliability and validity in employees and undergraduates, which can be used for measuring the core self-evaluation in practical research.     

中国军人心身健康量表的研制

目的 编制中国军人心身健康量表,并对其进行信、效度检验.方法 结合开放式问卷调查及以往研究,编制本量表.随机整群抽取1050名军人进行测试,并随机选择其中60名被试,同时施测中国心身健康最表(CPSHS);2周后对其中61名被试进行本量表的重测.通过探索性因子分析及相关分析,检验量表的信效度.结果 中国军人心身健康量表由11个因子构成:呼吸系、心血管系、消化系、骨骼肌肉、皮肤系、生殖内分泌系、神经系、焦虑、抑郁、精神病和家族史,另加一个掩饰分量表,经因子分析修正获得91个条目组成的正式量表.各因子之间的相关系数为0.103～0.778(P<0.01),各因子与总量表之间的相关系数为:0.600～0.859(P<0.01);总量表及各因子的重测相关系数为:0.427～0.901(P<0.01);Cronbach(α)系数为:0.618～0.935(P<0.01);分半相关系数为:0.349～0.855(P<0.01).本量表与CPSHS的对应因子呈显著性相关,相关系数为0.425～0.979(P<0.05或0.01).结论 中国军人心身健康量表具有较好的信度和效度,符合心理测量学要求.

Abstract：

Objective To develop a Chinese military psychosomatic health scale(CMPHS) and examine its reliability and validity. Methods Based upon the previous researches, the Scale was compiled according to open-ended inventory survey. The data was collected from 1050 subjects chosen by random cluster sampling. 60 of them were tested with the CPSHS at the same time, while 61 of them were retested with the CMPHS after two weeks. The reliability and validity were examined by exploratory factor analysis ( EFA) and correlation analysis. Results According to the factor analysis results, 11 factors were extracted, namely espiratory apparatus, alimentary system,skeletal and musculature,integument,regeneration and endocrine,nervous system, anxiety, depression, psy-choticism and family history. There were 91 items in the formal scale when one lie subscale was added. The correlation between subscales were 0. 103 ～ 0. 778 (P < 0. 01) , the correlation between subscales and total scale were 0.600 ～0.859(P<0.01). The test-retest correlation coefficients of total scale and subscales were 0.427 ～0.901 (P < 0.01); the Cronbach (α) coefficients were 0. 643 ～ 0. 935 (P < 0. 01) ; and the split-half correlation coefficients were 0. 349 ～ 0. 855 (P < 0. 01 ). The correlation coefficients were 0. 425 ～ 0. 979 (P < 0. 05 or 0. 01 ). Conclusion The Chinese military psychosomatic health scale has acceptable psychometrics properties on reliability and validity.     

Irritable bowel syndrome treated by traditional Chinese spinal orthopedic manipulation

OBJECTIVE:To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating irritable bowel syndrome(IBS) compared with pinaverium bromide Dicetel(PBD),and to assess a possible cause for IBS.METHODS:Two hundred ten IBS patients were randomly divided into the TCSOM group and the PBD group.All patients in the TCSOM group were treated with spinal manipulations 5 times.Pain intensity was assessed on a visual analogue scale and symptoms were evaluated based on bowel symptom scale(BSS) scores before and after treatment.A symptom improvement rating(SIR) was implemented to evaluate the effects of treatment,and to statistically compare theTCSOM and PBD groups.RESULTS:Post-treatment subjective assessment for the TCSOM treatment group showed that 92 cases had excellent results,10 cases had good results,3 cases had fair results,and 0 cases had poor results.In the PBD group,30 cases had excellent results,41 cases had good results,12 cases had fair results,and 22 cases had poor results.According to the SIR,which was based on the BSS,the TCSOM group included 92 cases with excellent results,10 cases with good results and 3 cases with poor results.There were no adverse side effects from treatment.Based on the BSS,the PBD group had 30 cases with excellent results,41 cases with good results,and 34 cases with poor results.We found that the symptom rating in the BSS in the TCSOM group showed a more significant improvement,such as a reduction in the severity and frequency of symptoms,compared with that in the PBD group(P<0.001).CONCLUSION:Displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region appears to be a contributing factor in the symptoms of IBS.Correcting this displacement of intervertebral discs and/or vertebra to resolve the stimuli caused by pressure exerted on the nerves and vessels around the spine is an effective treatment for IBS.     

中文版-听觉连续加法测试的信度效度检验及其相关因素研究

目的 检验中文版听觉连续加法测试(PASAT)在中国中青年人群中的信度、效度及其相关刎影响因素.方法 52名健康自愿者均接受PASAT、MMSE,并接受汉密尔顿抑郁量表、疲劳严重程度量表、匹兹堡睡眠质量指数评估.在初测后,抽取其中20名被试进入重测信度、评分者信度检验,抽取40名被试进入结构效度检验.结构效度检验还包括前瞻性记忆测试、听觉词语学习测试、符号数字转换测试、连线测试等等其他测试.结果 中文版PASAT内部一致性信度(cronbach's α=0.900)、重测信度(ICC=0.837,P=0.000)、评分者信度(ICC=0.999,P=0.000)良好,短期内具有练习效应(Z=-3.304,P=0.001);执行功能、工作记忆、文字记忆、时间前瞻记忆及逻辑归纳推理均参与PASAT任务完成;受教育年限与PASAT成绩显著正相关(r=0.582,P=0.000).结论 中文版PASAT具有良好信度、效度.受教育年限与中文版PASAT成绩存在显著相关性,其他如年龄、性别等因素的相关性有待进一步证实.

Abstract：

Objective To analyze reliability, validity and the correlative factors of the Chinese Paced Auditory Serial Addition Test (PASAT).Methods Fifty healthy subjects were assessed with PASAT, MMSE, Hamilton Depression Rating Scale(HAMD) ,the Fatigue Severity Scale and the Pittsburgh Sleep Quality Index( PSQI).After(7 ±2) days of the initial assessment,20 of the subjects were enrolled in the test-retest reliability and scorer reliability test,and 40 were taken into the construct validity test which included other 10 neuropsychological tests such as the Prospective Memory Test,the Chinese Rey Auditory Verbal Learning Test,the Symbol Digit Modalities Test,the Trail Making Test and so on.Results The internal consistency reliability ( cronbach' s α = 0.900 ),test-retest reliability ( ICC = 0.837, P = 0.000), score reliability ( ICC = 0.999, P = 0.000) of the Chinese PA-SAT were generally high.Practice effect were observed in short term ( Z = -3.304, P= 0.001 ).Executive function,working memory,verbal memory, time based prospective memory and the ability of logic reasoning were involved to complete the task of PASAT.There was a significant positive correlation of the PASAT results and the education years( r=0.582, P=0.000).Conclusion The Chinese PASAT has good reliability and validity for Chinese young and middle-aged people.Years of education and the Chinese PASAT were significantly related.On the other hand, the relationship of the Chinese PASAT and other factors, such as age and gender, should be further explored in future.     

Expression of phosphorylated-STAT3 and osteopontin and their correlation in melanoma

The expressions of p-STAT3 and osteopontin in 22 cases of normal nevi and 43 cases of malignant melanoma were immunohistochemically detected, and the correlation between p-STAT3 and osteopontin in malignant melanoma and the correlations of p-STAT3 （or osteopontin） with invasion, metastasis and thickness of malignant melanoma were examined. The results showed p-STAT3 was expressed in 2 of 22 cases of normal nevi and 30 of 43 cases of malignant melanoma, while osteopontin was expressed in 3 cases of normal nevi and 29 cases of malignant melanoma. The expressions of p-STAT3 and osteopontin in melanoma were significantly higher than that in benign nevi. There existed significant correlations between the expression of p-STAT3 and that of osteopontin in melanoma. Furthermore, the expression rates of p-STAT3 were significantly higher in invasive or metastatic melanomas than that their non-invasive or non-metastatic counterparts, and the expression rates of osteopontin were significantly higher in invasive melanomas than that in non-invasive ones. It is concluded that p-STAT3 and osteopontin may play important roles in the pathogenesis of malignant melanoma.     

Quantitative study of AgNOR in differential diagnosis between non-Hodgkin''s lymphoma and reactive hyperplasia.

The argyrophilic staining technique was used in differential diagnosis between non-odgkin's lymphoraa (NHL) and reactive hyperplasia (RH) of lymphatic tissues in 30 cases of RH and 71 cases of NHL which were classified as low (11 cases), moderate (49 cases) and high malignant (11 cases) groups. The mumber and the area of Ag nucleolar organizer region (AgNORs) in 100 cells of each case were examined by both IBAS-200 cytoimage analyser and microscope. The results showed that there was significant difference in the number, but not in area, of AgNOR granules between RH and low malignant group of NHL (P< 0.001). In NHL, the significant differences in the number and area of AgNORs were found between each groups (P<0.05 or P< 0.001). It was also observed that in NHL, the number of AgNOR was negatively correlated with the area of the granules, and the shapes and distribution patterns of AgNOR were significantly different between each groups. Our results suggest that the quantitative study of AgNOR combining wit     

综合康复治疗对长期住院慢性精神分裂症患者生活质量及社会功能的影响

目的探讨综合康复治疗对慢性精神分裂症患者生活质量和社会功能的影响。方法将117例病情稳定的长期住院精神分裂症患者随机分为治疗组58例及对照组59例。治疗组在药物治疗的基础上给予系统的康复治疗,对照组只给予药物治疗。康复治疗前后分别应用简明精神病评定量表(BPRS)、生活质量综合评定问卷-74(GQOLI-74)以及住院慢性精神分裂症社会功能评定量表(SSPI)综合评价患者的康复情况。结果综合康复治疗第6个月后,治疗组BPRS评分显著低于治疗前(P<0.05),且治疗后9个月、12个月治疗组优于对照组(P<0.05);治疗组治疗后6～12个月GQOLI-74心理健康因子、社会功能因子评分、SSPI评分均高于治疗前(P<0.05),且治疗12个月时心理健康社会功能优于对照组,治疗6～12个月时SSPI评分优于对照组(P<0.05)。结论综合康复治疗能提高长期住院慢性精神分裂症患者的生活质量及社会功能。     

慢性精神分裂症患者社会功能缺陷及家庭干预

目的 了解慢性精神分裂症患者社会功能缺陷及家庭干预的效果.方法 采用社会功能缺陷筛选量表(SDSS)对96例病程≥5年,符合CCMD-3R精神分裂症诊断标准的门诊患者的社会功能缺陷状况进行测查.采用简明精神病评定量表(BPRS)评定疗效,按就诊先后顺序随机分为干预组和对照组各48例,只对干预组实施家庭干预,然后对两组患...     

症状自我监控程式训练在稳定期男性精神分裂症患者中的应用效果

目的探讨症状自我监控程式训练在稳定期男性精神分裂症患者中的应用效果。方法选取稳定期男性精神分裂症患者110例,根据住院号分为训练组和对照组,每组55例。2组患者均给予药物治疗、常规护理及一般的康复训练治疗,训练组在此基础上再进行8周的症状自我监控程式训练,然后随访6个月。采用简明精神病评定量表(BPRS)和社会功能缺陷筛选表(SDSS)对2组患者进行对比评估。结果治疗前2组患者BPRS、SDSS评分比较差异均无统计学意义(P>0.05)。训练8周末及随访6个月末2组患者BPRS、SDSS评分比较差异均有统计学意义(P<0.05)。训练8周末训练组复发率为2.0%(1/50),对照组复发率为9.1%(5/55),2组复发率比较差异无统计学意义(P>0.05);随访6个月末训练组复发率为6.0%(3/50),对照组复发率为14.5%(8/55),2组复发率比较差异有统计学意义(P<0.05)。结论症状自我监控技能程式训练有益于稳定期男性精神分裂症患者疗效的长期保持。     

中文版青少年久坐行为量表在初中生应用的信度和效度研究

目的 评价中文版青少年久坐行为量表在初中生应用的信度和效度.方法 采用多阶段抽样的方法 ,对782名初中生进行问卷调查.用Cronbach's α系数和分半信度考核其信度,用条目-维度相关系数(IIC)、维度间相关系数、总分与维度间的相关系数考核其内容效度,用证实性因子分析考核其结构效度.结果 中文版青少年久坐行为量表的Cronbach's α系数为0.822,改变策略、决策平衡正面效应维度、决策平衡负面效应、自我效能四个维度的Cronbach's α系数分别为0.882,0.478,0.631,0.645;总量表分半信度为0.857,各维度分半信度在0.488～0.896;条目与维度间平均相关系数0.226～0.768,除决策平衡负面效应得分与改变策略、决策平衡正面效应得分间的相关系数分别为-0.052,0.090(P＜0.05)外,其他各维度得分间有较弱到中度的相关关系(r=-0.210～0.394,P＜0.01),4个维度得分与总分间均有中度到较强的相关关系(r=0.365～0.554,P＜0.01).结论 中文版青少年久坐行为量表在初中生中具有较好的信度和效度,在整体上适用于国内初中生久坐行为的测量.     

农村首发精神分裂症患者亲属健康教育的10年随访

目的探索健康教育对农村首发精神分裂症患者康复的影响.方法将符合入组标准的100例农村首发精神分裂症患者分为健康教育组和对照组(每组50例).两组均给予相仿的药物治疗,其中健康教育组亲属同时接受住院期间和出院后的健康教育,对照组则否.于入组时、随访半年、1年、3年、5年、10年末采用简明精神病量表(BPRS)、社会功能缺陷筛选量表(SDSS)、家庭环境量表中文版(FES-CV)评定病情、社会功能及家庭环境变化,并统计复发情况.结果入组时健康教育组和对照组比较,BPRS、SDSS、FES-CV评分差异无显著性(P＞0.05).随访半年时,健康教育组BPRS、SDSS评分均低于对照组(P＜0.05,FES-CV中亲密性、文化性、娱乐性评分均高于对照组(P＜0.05),情感表达、矛盾性均低于对照组(P＜0.05),并持续至随访结束.且随访结束时健康教育组复发人次显著少于对照组(P＜0.05).结论健康教育使农村首发精神分裂症患者的复发率降低,社会功能残疾程度减轻,家庭环境改善.     

人性化护理对男性精神病患者社会功能的影响

目的:探讨人性化护理对男性精神病患者社会功能的影响。方法:男性精神病患者129例,其中64例进行常规护理（对照组）,65例实施人性化护理干预（观察组）。采用住院精神患者社会功能评定量表（SSPI）和自知力与治疗态度问卷（ITAQ）对2组患者干预前后的社会功能进行评价和比较。结果:干预前2组患者SSPI和ITAQ评分差异均无统计学意义（P>0.05）。干预后2组患者SSPI和ITAQ评分均较干预前明显升高（P<0.01）,且观察组患者SSPI总分及各因子评分与ITAQ总分均明显高于对照组（P<0.01）。结论:人性化护理有利于改善男性精神病患者社会功能,值得临床推广。     

解离特质量表编制及信效度分析

目的 编制解离特质量表并检验其信效度.方法 根据文献和心理测量学原理编制解离特质量表,对1306名大学生进行测试,并测试症状自评量表(SCL-90)作为效标.结果 ①探索性因子分析得到8个因子,分别为出神、现实解体、躯体化、人格解体、自我调节、情感麻木、疏忽遗忘、时空混乱,可解释总方差的57.69%.②总量表和8个因子分量表的Cronbach'α系数分别为0.969,0.889,0.907,0.874,0.890,0.892,0.872,0.855,0.830,重测信度分别为0.763,0.585,0.677,0.613,0.651,0.684,0.621,0.575,0.638(P＜0.01).③解离特质量表总分和各因子分数分别与SCL-90总分和各因子分数呈正相关(r=0.200～0.714,P＜0.01).结论 解离特质量表在大学生中具有良好的信效度,可作为评估解离特质水平的测量工具.

Abstract：

Objective To develop the Dissociative Trait Scale(DTS),and examine its reliability and validity. Methods Based on literature and research work,a preliminary questionnaire was designed to measure dissociative trait. 1306 college students completed the DTS and Symptom Checklist 90(SCL-90). Results Exploratory factor analysis extracted eight factors. The percentage of variance explained was 57.69％. The Cronbach α-coefficient of the total scale and the eight subscales ranged from 0. 830 ～ 0. 969, the test-retest reliability ranged from 0.575 ～ 763 (P ＜ 0.01 ). The scores of DTS significantly positively correlated with the scores of SCL-90 (P ＜0.01 ). Conclusion The DTS has acceptable psychometric quality,and can be applied to assess dissociative traits in Chinese college students.     

药物自我处置程式训练对精神分裂症社会功能影响的对照研究

目的 探讨药物自我处置程式对精神分裂症患者治疗依从性及社会功能的影响.方法将66例住院非急性期精神分裂症患者随机分为训练组(n=33)和对照组(n=33).在抗精神病药物治疗不变的前提下,训练组按药物自我处置程式进行分组训练8周.采用自制的药物依从性评分表和工作能力评分表、社会功能缺陷量表(SDSS)表对2组患者评估.结果 训练组8周后及随访6个月治疗依从性、SDSS总分与对照组比较差异有显著性:治疗依从性(χ~2=9.188,29.630,P<0.01);SDSS总分[(2.63±2.74)分,(5.27±3.05)分,(1.69±2.35)分,(4.91±3.06)分,P=0.000];训练组随访6个月工作能力与对照组比较差异有显著性(χ~2=19.443,P=0.000).同组不同时点比较,训练组8周时患者治疗依从性(χ~2=8.053,P=0.018)、SDSS总分[(2.63±2.74)分,(6.81±3.06)分,P=0.000]较入组时有显著提高;2组随访6个月的治疗依从性均下降且与8周时有显著性差异(P<0.01).相关分析显示,患者SDSS总分在随访6个月时与治疗依从性及工作能力呈正相关.结论 药物自我处置程式训练能提高患者的治疗依从性,改善其的社会功能和工作能力.     

精神分裂症患者“药物自我处置程式”训练的研究

目的探讨“药物自我处置程式”训练对精神分裂症患者治疗依从性、社会功能和生活质量的影响。方法将66例住院非急性期精神分裂症患者随机分为训练组（n=33）和对照组（n=33）。在抗精神病药物治疗不变的前提下,训练组按照Liberman编写的“药物自我处置程式”进行分组训练8周,8周后两组随访6个月。采用自制的药物依从性评分表、社会功能缺陷量表（SDSS）、生活质量综合评定问卷（CQOLI-74）对两组患者进行评估。结果8周及随访6个月后训练组治疗依从性、SDSS总分、GQOLI-74总分较对照组显著提高（P〈0．01、P〈0．05）。同组不同时点比较,训练组8周及随访6个月患者治疗依从性、SDSS总分、GQOLI-74总分等较入组时有显著提高（P〈0．01或P〈0．05）;两组随访6个月的治疗依从性下降,且与8周时的差异有统计学意义（P〈0．01）。相关分析显示,在8周和随访6个月后,患者GQOLI-74总分与SDSS总分、治疗依从性呈负相关,SDSS总分与治疗依从性呈正相关（P〈0．01）。结论“药物自我处置程式”训练能提高患者的治疗依从性,改善其社会功能,提高其生活质量。     

儿童少年精神分裂症复发因素分析

目的探讨儿童少年精神分裂症复发的因素并提出应对策略。方法随访在新乡医学院第二附属医院治疗的166例儿童少年精神分裂症患者2 a,将2 a内患儿复发2次以上的60例为复发组,病情稳定2 a以上未复发患者60例为对照组,病情无明显缓解患者(27例)和脱落患者(19例)不计入统计分析。评定复发组和对照组病情严重程度、家庭经济状况、父母受教育年限、患者自知力、起病年龄、药物不良反应、服药依从性等因素对复发的影响。结果2组患儿在不同经济收入家庭中的分布比较差异有统计学意义(χ2=6.351,P=0.042),在不同受教育年限的家庭和有无自知力方面中的分布差异无统计学意义(χ2=3.472、3.142;P=0.176、0.076);起病年龄和阳性与阴性症状量表评分2组比较差异无统计学意义(t=1.313、-0.955;P=0.192、0.341);2组锥体外系反应量表(RSESE)评分、UKU不良反应量表评分、服药依从性评分比较差异有统计学意义(t=-2.094、2.058、-2.932;P=0.038、0.042、0.004)。服药依从性与RSESE评分、UKU不良反应量表评分呈负相关(r=-0.546、-0.569,P=0.000、0.000);RSESE评分、UKU不良反应量表评分一致性很高(r=0.968,P=0.000)。结论经济状况和药物不良反应而导致服药依从性差是导致儿童少年精神分裂症复发的主要因素;减少药物不良反应、坚持药物治疗是防止精神分裂症复发的有效途径。