社区精神分裂症患者居家康复现状与研究进展

目的分析居家精神分裂症患者精神症状现况及相关影响因素，为帮助患者实现更好的居家康复提供参考。方法整群抽取上海市金山区朱泾社区在册管理的371名居家精神分裂症患者，开展随访调查，掌握患者的一般人口学资料、家庭情况、病情现状及治疗情况等。对影响患者精神症状的各因素采用单因素和多因素logistic回归分析。结果371名患者均完成随访调查，精神症状阳性患者121例(阳性率32.61%)；单因素分析结果显示：经济情况、病程(年)、危险行为等级、自知力、住院情况以及参加工作情况比较差异有统计学意义(P < 0.05)，不同性别、年龄、文化程度、婚姻状况、病程、家族史、残疾鉴定、监护情况、服药依从性、免费服药比较差异无统计学意义(P>0.05)；多因素logistic分析结果显示：自知力完全(OR=0.488，95%CI：0.284~0.838)、参加工作(OR=0.469，95%CI：0.257~0.857)为保护因素(P < 0.05)。结论加强居家精神分裂症患者服务管理，完善定期随访和看护机制，对有精神症状阳性的患者积极动员送院规范治疗。提高患者的自知力，帮助患者提高劳动工作能力，对于预防控制居家精神分裂症患者的精神症状、提高其生活质量具有重要的临床和社会意义。

Risk factors for relapse following treatment for first episode psychosis:a systematic review and meta-analysis of longitudinal studies

ObjectiveTo analyze the current status of mental symptoms and related influencing factors in patients with schizophrenia, and to provide reference for helping patients achieve better home rehabilitation.MethodsCluster extraction was done of 371 home schizophrenia patients registered in the community, and follow-up surveys were carried out for general demographic data, family status, current status of the disease, and treatment status.Univariate and multivariate logistic regression analysis was used for each factor in affecting the patient′s mental symptoms.ResultsAll of the 371 patients completed follow-up surveys, and 121 patients with positive psychotic symptoms (positive rate 32.61%).Univariate analysis showed that differences in the economic situation, course of illness(years), risk behavior level, self-knowledge, hospitalization and working status were statistically significant (P < 0.05), while differences in gender, age, education level, marital status, disease course, family history were not.And there was no significant difference in the disability identification, monitoring status, medication compliance, and free medication (P>0.05).Multivariate logistic analysis showed that complete self-knowledge(OR=0.488, 95%CI:0.284-0.838), and participation in work(OR=0.469, 95%CI:0.257-0.857) were protection factors (P < 0.05).ConclusionThe service management of patients with schizophrenia at home should be strengthened, regular follow-up and nursing care mechanisms should be improved, and patients with positive mental symptoms should be actively mobilized for hospitalized treatment.Improving the patient′s self-knowledge and helping patients improve their ability to work and work is the key to preventing mental symptoms in patients with schizophrenia.