首发精神分裂症患者精神病治疗前期间影响因素与临床疗效关系的流行病学研究

目的 探讨首发精神分裂症患者精神病治疗前期间(duration of untreated psychosis,DUP)的影响因素及临床疗效和DUP的关系.方法 对912例首发精神分裂症患者的病案资料进行流行病学调查.收集患者的一般资料、临床诊断及临床疗效.参考精神分裂症首发症状评定量表评估患者的DUP.根据DUP的中位值将患者分为短DUP和长DUP2组.结果 短DUP与长DUP2组间婚姻比较差异具有显著性(P<0.05),其中未婚在短DUP组频数分布(63.7%)高于长DUP组(52.6%),差异具有显著性(λ2=5.990,P<0.05),离婚在短DUP组频数分布(0.6%)低于长DUP组(4.4%),差异具有显著性(λ2=15.079,P<0.01).精神分裂症单纯型在短DUP组频数分布(1.5%)低于长DUP组(4.1%),差异具有显著性(λ2=5.868,P<0.05).2组临床疗效间的比较差异具有显著性(λ2=36.093,P<0.01),2组临床疗效间Ridit分析显示差异有显著性(u=5.183,P<0.01).多因素Logistic回归分析发现婚姻、发病年龄和临床诊断对DUP有显著影响.结论 在首发精神分裂症患者中,婚姻、发病年龄和临床诊断对DUP有影响,DUP越长其临床疗效越差.

The influencing factors of duration of untreated psychosis and the relationship between DUP and treatment outcome in epidemiological first episode schizophrenia

Objective To explore the influencing factor of duration of untreated psychosis(DUP) and the relationship between duration of untreated psychosis and treatment outcome in epidemiological first-episode schizophrenia. Methods 912 medical records of the first episode schizophrenia patients were recruited in the study for epidemiological survey . The general medical data, clinical diagnosis, and treatment outcome were collected. DUP was determined refer to symptom onset for schizophrenia (SOS) scale. Patients were divided into short DUP and long DUP groups according to the median values of DUP values. Results Between short DUP and long DUP groups, the difference in marriage was significant ( P < 0. 05). The unmarried patients in the short DUP group (63.7% ) was higher than the long DUP group (52.6% ), the variance was significant (λ2 =5.990, P<0.05). The divorce in the short DUP group (0.6% ) was lower than the long DUP group (4.4% ) , the variance was significant (λ2 =5.079, P<0.01).The simple schizophrenia in the short DUP group (1.5%) was lower than the long DUP group (4. 1% ) , the variance was significant (λ2 =5.868, P<0.05). The treatment outcomes between the two groups had a significant variance ( λ2 =36.093, P < 0.01) , and the Ridit analysis of treatment outcomes between the two groups showed significant difference ( u = 5.183, P<0.01). The marriage,age of onset and clinical diagnosis were significantly correlated with DUP in multiple factor Logistic regression analysis. Conclusion The marriage,age of onset and clinical diagnosis are significantly correlated with DUP in the first episode schizophrenia patients,the longer of DUP and the worse of treatment outcome.