社区精神疾病患者生活能力调查分析

目的：探讨社区精神疾病患者社会、家庭生活能力及其影响因素。方法：在社区中,对精神疾病患者开展问卷调查、日常生活能力量表（ADL）、社会功能缺陷量表（SDSS）调研。结果：已婚精神疾病患者的日常生活能力优于未婚者,女性患者社会功能恢复较男性好,经济收入较高的患者生活能力和社会功能也显著较好。结论：婚姻可提高日常生活能力,经济收入与之有相互因果的作用。     

药物联合绘画艺术治疗对精神分裂症住院患者康复期生活质量的影响

目的探究药物联合绘画艺术治疗对精神分裂症住院患者康复期病情、社会功能及生活质量的影响。方法选取2014年1月-2016年1月在广东省茂名市第三人民医院进行康复治疗的精神分裂症患者120例,采用随机数字表法分为实验组和对照组各60例,两组均给予奥氮平单药治疗,起始剂量5 mg/d,根据患者病情适量增加,最大不超过10 mg/d;实验组在此基础上联合绘画艺术治疗,两组均治疗8周。采用简明精神病评定量表(BPRS)、社会功能缺陷筛选量表(SDSS)和生活质量综合评定问卷-74(GQOLI-74)评定两组病情严重程度、社会功能及生活质量。结果治疗前与治疗后3个月,两组BPRS、SDSS、GQOLI-74评分比较差异无统计学意义(P0.05)。治疗后6个月,两组BPRS、SDSS评分均低于治疗前(P均0.05),GQOLI-74评分均高于治疗前(P0.05),且实验组BPRS、SDSS评分低于对照组(P均0.05),GQOLI-74评分高于对照组(P0.05)。结论药物联合绘画艺术治疗较单用药物治疗可能更有助于改善精神分裂症患者精神状况及社会功能水平,提高生活质量。     

家庭干预对精神分裂症患者生活质量的影响

目的：探讨家庭干预对精神分裂症患者的生活质量及社会功能的作用。方法：对60例生活质量及社会功能明显下降的精神分裂症患者进行为期1年家庭干预。采用生活质量量表（QOL），简明精神病评定量表（BPRS）及社会功能缺陷筛选表（SDSS）进行干预前后评分。结果：1年后BPRS、SDSS、QOL评分大多项目较干预前有改善。结论：家庭干预能提高精神分裂症患者生活质量，改善社会功能，降低复发率。     

社区综合干预对慢性精神分裂症患者生活质量的影响

目的：探讨社区综合干预对慢性精神分裂症患者生活质量和服药依从性的影响。方法：120例慢性精神分裂症患者,随机分成研究组和对照组,各60例。研究组进行社区综合干预,对照组只进行药物治疗。入组前后实施简明精神病评定量表（BPRS）、生活质量综合评定问卷74（GQOLI-74）以及自知力与治疗态度问卷（ITAQ）评定。结果：治疗12个月研究组BPRS评分显著低于对照组（P〈0．05）;研究组GQOLI-74心理健康因子评分和社会功能因子评分显著高于对照组（P〈0．05）;研究组ITAQ评分显著高于对照组（P〈0．05）。结论：社区综合干预能改善慢性精神分裂症患者的生活质量,提高服药依从性。     

已婚精神分裂症门诊患者生活质量初探

目的考察已婚精神分裂症门诊患者生活质量的特点,并检测生活质量综合评定问卷(GQOLI-74)在精神分裂症患者中的适用性.方法根据施测数据检验GQOLI-74同质性信度和内部结构效度,同时运用GQOLI-74评定120例已婚精神分裂症门诊患者和正常对照组60人的生活质量,并考察两组间生活质量的差异.应用一般资料调查表、BPRS和TESS对精神分裂症患者的社会人口统计学特征,精神症状和治疗的副反应进行检测,考察精神分裂症门诊患者生活质量的主要影响因素.结果GQOLI-71在精神分裂症患者中表现出较好的同质性信度和内部结构效度.已婚精神分裂症门诊患者的社会功能显著差于正常对照组.精神症状和药物副反应是影响患者生活质量的主要因素,其中,以精神症状的影响最大.结论GQOLI-74适用于精神分裂症患者;精神分裂症患者的社会功能差,有被社会和家庭隔离的倾向;能否有效地控制精神症状对提高患者生活质量十分重要.     

综合护理干预对精神分裂症患者社会功能的影响

目的 探讨综合护理干预对精神分裂症患者社会功能的影响.方法 将2010 ～ 2013年在我院住院的92例精神分裂症患者随机分为研究组和对照组,每组各46例.对照组患者给予常规护理,研究组在常规护理干预基础上给予综合护理干预.分别在入组时及干预后第4、8周末采用日常生活活动能力量表（ADL）和社会功能缺陷量表（SDSS）进行评定.结果 两组干预后8周末的ADL评分均高于入组时（P＜0.05）,且研究组评分高于对照组（P＜0.05）.研究组干预后8周末SDSS评分低于入组时（P＜0.05）;且研究组评分低于对照组（P＜0.05）.结论 综合护理干预能够提高精神分裂症患者的社会功能与日常生活活动能力.     

社会心理干预对慢性精神分裂症患者生活质量的影响

目的探讨社会心理干预对慢性精神分裂症患者生活质量的影响。方法将80例慢性精神分裂症患者随机分为干预组和对照组，各40例，对照组单用药物治疗，干预组合并社会心理干预。在人组时及第6、12个月分别对两组采用PANSS评定患者病情，社会功能缺陷筛选量表（SDSS）和生活质量综合评定问卷（GQOLI-74）评定患者社会功能及生活质量。结果干预组SDSS总分在6个月及12个月时均显著低于对照组，干预组GQOLI-74评分在6个月和12个月时除物质生活维度外，其他三个维度均显著高于对照组。两组PANSS评分则无显著性差异。结论社会心理干预可改善患者社会功能，提高患者生活质量。     

立体定向颅内多靶点毁损术治疗难治性精神分裂症的远期预后分析

目的探讨立体定向手术治疗难治性精神分裂症的远期疗效。方法回顾性分析应用立体定向多靶点毁损手术治疗的826例难治性精神分裂症患者的临床资料,对术后回访超过5年的348例患者设立非手术对照组,采用简明精神病量表（BPRS）、阳性和阴性症状量表（PANSS）、社会功能缺陷量表（SDSS）和日常生活能力量表（ADL）等对远期预后进行评定。结果长期随访,手术组与非手术组（BPRS）中的激活因子分、PANSS中的攻击危险性和偏执／好斗因子分有显著性差异（P〈0．01）,SINS和ADL评分两组间的差异无显著性（P〉0．05）。结论脑立体定向手术对临床确诊的难治性精神分裂症靶症状疗效是肯定的,对患者的社会和生活能力无明显影响。     

会所模式综合干预对精神分裂症患者社会功能康复的对照研究

目的观察会所模式综合干预对精神分裂症患者出院后社会功能康复的疗效。方法对出院的精神分裂症患者分为干预组（83例）和对照组（72例）,其中干预组为自愿入会所的出院患者;对照组仅进行门诊随访。在入组时、1、2年末分别对两组患者采用日常生活能力量表（ADL）[包括躯体生活自理量表（PSMS）和工具性日常生活能力量表（IADL）两个分量表]和社会功能缺陷筛选量表（SDSS）进行评估。结果入组时,对照组和干预组的PSMS、IADL和SDSS评分差异无显著性（P〉0.05）;1年末,干预组PSMS、IADL和SDSS评分均低于对照组,差异具有显著性（P〈0.05）;2年末,干预组PSMS、IADL和SDSS评分均明显低于对照组,差异具有显著性（P〈0.05）。2年末,干预组PSMS、IADL和SDSS评分均低于干预1年末时的评分,差异具有显著性（P〈0.05）。结论会所模式综合干预有利于出院后精神分裂症患者的日常生活能力的提高和社会功能康复。     

对社区慢性精神分裂症患者个体化康复治疗的近期效果

目的探讨对慢性精神分裂症患者个体化康复治疗的近期效果。方法抽取上海市虹口区社区慢性精神分裂症患者，随机分为干预组和对照组；对干预组进行为期4月的个体化康复治疗；在基线收集一般资料，并在基线和干预结束后使用简明精神病量表（The Brief Psychiatric Rating Scale，BPRS）、副反应量表（Treatment Emergent Symptom Scale，TESS）、社会功能缺陷筛选量表（Social Disability Screening Schedule，SDSS）、日常生活能力量表（Activity of Daily Living Scale，ADL）、功能活动调查表（Functional Activites Questionaire，FAQ）、药物依从性以及不良反应报告（自制）等评定。结果人组的干预组20例和对照组14例，诊断均为精神分裂症，两组在年龄、性别、受教育程度、病程、住院次数、家族史均为统计学差异。基线两组的各个量表得分均无统计学差异，随访时两组在BPRS总分、BPRS缺乏活力因子两项存在统计学差异。干预组在个体化康复治疗后BPRS总分、BPRS缺乏活力因子、BPRS思维障碍因子、BPRS激活性、TESS、SDSS、FAQ共7项得分较治疗前分值降低。对照组在随访时仅有SDSS共1项得分较基线增高。结论个体化康复治疗能够改善慢性精神分裂症患者的精神症状和社会适应等社会功能，以及降低药物副反应。     

出院精神分裂症患者实施居家优质护理管理的效果分析

目的:探讨居家优质护理管理对出院精神分裂症患者的效果。方法:120例出院精神分裂症患者随机分为干预组和对照组各60例,两组均采用常规出院护理模式,干预组增加由临床医生、护士、心理咨询师组成的团队参与社区管理,设定干预项目,通过网络、短信、电话等进行护理干预,并采用日常生活能力量表(ADL)、精神分裂症患者生活质量量表(SQLS)、中文版一般自我效能感量表(GSES)及自拟"居家护理服务满意度调查表"在干预前、干预3个月、6个月和12个月后对两组进行评估,并在日常生活能力、生活质量、自我效能感及满意度方面进行比较。结果:重复测量方差分析显示,两组ADL及GSES评分组间主效应有统计学意义(F=975.78,P0.001;F=7.84,P=0.006);ADL、SQLS及GSES评分时间主效应有统计学意义(F=20.02,F=36.62,F=43.14;P均0.001)。干预组干预前后患者满意度时间主效应有统计学意义(F=68.83,P0.001)。结论:对出院精神分裂症患者实施居家优质护理管理可明显加强日常生活能力、改善生活质量、提高自我效能感及满意度。     

Is quality of life associated with cognitive impairment in schizophrenia?

BACKGROUND: The subjectively assessed quality of life of schizophrenia patients is mostly lower than healthy subjects, and cognitive impairment is an integral feature of schizophrenia. The aims of the present study were to compare the quality of life and neurocognitive functioning between the patients with schizophrenia and the healthy subjects, and to examine the relationships between quality of life and neurocognitive functions among the patients with schizophrenia. METHODS: Thirty-eight patients with schizophrenia (15 women and 23 men) and 31 healthy individuals (18 women and 13 men) were included in the study. All participants were administered World Health Organization Quality of Life-Brief Form (WHOQOL-BREF) to assess their quality of life, and Digit Span Test (DST) and Controlled Oral Word Association Test (COWAT) for cognitive functions. RESULTS: The patients with schizophrenia demonstrated lower scores in physical (F=25.6, p=0.0001), psychological (F=15.85, p=0.0001) and social (F=37.7, p=0.0001) domains compared to control group. The patients with schizophrenia showed significantly lower scores on COWAT compared to healthy subjects (F=4.22, p=0.04). The social domain scores of WHOQOL correlated to DST total scores (r=0.45, p=0.007), DST forwards scores (r=0.54, p=0.001) and COWAT total scores (r=0.40, p=0.04) in patients with schizophrenia but not in the control group. The patients with lower level of cognitive functioning had lower scores on social domain of WHOQOL-BREF (z=-2.01, p=0.04). CONCLUSION: Our results confirm that the cognitive deficits in executive function and working memory appear to have direct impact on the patients' perceived quality of life especially in social domain which can either be a cause or a consequence of social isolation of patients with schizophrenia.     

伴有抑郁的脑梗死患者生存质量

目的：探讨急性期脑梗死患者抑郁心理对其特异性生存质量的影响。方法：急性期脑梗死患者142例，经Zung抑郁自评量表（SDS）评分后分为无抑郁组50例，轻度抑郁组36例和中度抑郁组56例。运用脑卒中影响量表（SIS）评定3组患者的生存质量。结果：在SIS的8个维度中，轻度抑郁组在体力，记忆/思维，情绪，日常活动能力，社会参与等维度的评分低于无抑郁组（P〈0.05）。中度抑郁组在体力，记忆/思维，日常活动能力，行动能力，社会参与等维度的评分低于轻度抑郁组（P〈0.05或P〈0.001）。中度抑郁组除手功能外的其他各维度评分明显低于无抑郁组（P〈0.05或P〈0.001）。结论：脑梗死患者抑郁程度与其生存质量密切相关，抑郁程度重者生存质量较差。     

The relation of social support-seeking to quality of life in schizophrenia

Social support-seeking has been shown to improve the outcome of schizophrenia. However, no study to date has documented the impact of social support seeking on self-perceived quality of life in schizophrenia, particularly not on the relation between symptoms and quality of life. The present study explored this issue with a sample of 58 outpatients diagnosed with schizophrenia without comorbidity. Social support seeking, symptoms (positive, negative, and extrapyramidal), and multidimensional self-reported quality of life were assessed cross-sectionally. Negative symptoms were inversely related to the quality of life domain of activities of daily living. Other symptoms and social support-seeking were not related to quality of life, and social support-seeking did not interact with symptoms in their relation to quality of life. Social support-seeking may thus not be beneficial (nor disruptive) as a way of coping with symptoms in schizophrenia. More studies are needed in order to investigate the relation of social support-seeking to symptoms and to quality of life in serious mental illnesses such as schizophrenia, so that interventions with persons suffering from these disorders may be better guided.     

Anxiety disorders in outpatients with schizophrenia: prevalence and impact on the subjective quality of life

OBJECTIVE: To describe the prevalence of comorbid lifetime anxiety disorders in outpatients with schizophrenia and to compare the subjective quality of life of patients with and without comorbid anxiety disorders. METHODS: Fifty-three outpatients were recruited. They were interviewed with the Anxiety Disorders section of the SCID for DSM-IV. Quality of life was assessed with the Sheehan disability scale (SDS). RESULTS: Specific prevalences of anxiety comorbidity were: social phobia (17%), OCD (15.1%), GAD (9.4%), anxiety disorder NOS (7.5%), panic disorder (5.7%), specific phobia (5.7%), PTSD (3.8%), and agoraphobia (1.9%). Schizophrenic patients with comorbid anxiety disorder (41.5%) showed significantly higher scores in global scale (p=0.005), work subscale (p=0.007), and social life subscale (p=0.003) of the SDS than their counterparts without comorbid conditions. CONCLUSIONS: Anxiety disorders may impose an additional burden to patients with schizophrenia, resulting in further decline in their subjective quality of life.     

首发精神分裂症患者的生活质量评估

目的评估首发分裂症患者的生活质量，及生活质量与精神症状的相关性。方法评估447例患者基线、随访6个月、随访1年时阳性和阴性症状量表（PANSS）、健康状况调查问卷（SF-36）、社会功能缺陷筛选量表（SDSS）、生活满意度量表（LSR）。主要根据SF-36评估首发分裂症患者的生活质量，并将SF-36与PANSS、SDSS、LSR作相关分析。结果首发精神分裂症患者在躯体角色功能（RP）、社会功能（SF）、情绪角色功能（RE）3个维度平均分显著低于杭州市居民的数据。除精力（VT）外，其余7个维度与PANSS的阳性症状分、阴性症状分、一般精神病理分以及SDSS均呈负相关，与LSR呈正相关。而VT与PANSS的阴性症状分及LSR呈负相关。随访1年问躯体健康（PF）、躯体角色功能（RP）、躯体疼痛（BP）、总体健康（GH）、社会功能（SF）、情绪角色功能（RE）、心理健康（MH）等7个维度得分显著提高。结论首发分裂症患者的情绪角色功能、躯体角色功能和社会功能受损明显，经1年治疗后上述功能均能明显改善。除精力感外，精神症状缓解越明显，生活质量越高，提示了早期治疗的重要性。同时也表明SF-36可适用于评估分裂症患者的生活质量。     

Quality of life in community-dwelling patients with schizophrenia in China

The aim of this study was to assess Chinese schizophrenia patients' quality of life (QOL) and identify its demographic and clinical correlates. A random sample of 540 community-dwelling schizophrenia patients was interviewed using standardized assessment instruments. The patients' basic sociodemographic and clinical data and QOL were collected. Compared with the general population, patients had significantly lower scores in the physical and psychological QOL domains. Multivariate analyses showed that better social support independently predicted higher QOL in all domains, whereas more severe positive symptoms predicted worse psychological and environmental domains. Overall psychopathology predicted both worse physical and psychological domains; depressive symptoms and being married predicted worse physical and social QOL, respectively. Our results suggest that therapeutic and psychosocial interventions alleviating positive and depressive symptoms and improving poor social support and marriage-related problems in Chinese patients with schizophrenia might be of considerable benefit in improving their QOL.     

Lower subjective quality of life and the development of social anxiety symptoms after the discharge of elderly patients with remitted schizophrenia: a 5-year longitudinal study

ObjectivesRemitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of “deinstitutionalization.” The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life.MethodsFifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization–Quality of Life 26 (WHO-QOL26).ResultsThirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms.ConclusionIn community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social anxiety may be needed.     

全程干预对首发精神分裂症患者的影响

目的:探讨全程综合性干预对首发精神分裂症患者社会功能及生活质量的影响。方法:将116例首发精神分裂症患者随机分为干预组和药物组各58例,其中脱落7例。两组均接受抗精神病药治疗,干预组同时接受全程综合干预措施1年。采用简明精神病评定量表(BPRS)、住院病人护士观察量表(NOSIE-30)、社会功能缺陷量表(SDSS)和生活质量综合评定问卷(GQOLI)分别于入组时及干预结束时进行评估。结果:入组时,两组所有量表评分差异均无显著性;干预结束时,干预组的BPRS、NOSIE-30中的总消极因素及SDSS评分均明显低于药物组;而NOSIE-30总分、总积极因素及GQOLI评分均明显高于药物组。结论:全程综合性干预措施有助于改善首发精神分裂症患者的精神症状,促进其社会功能的恢复,提高其生活质量。