综合干预对农村精神分裂症患者预后的影响

目的 探讨生物-心理-社会综合干预对农村社区精神分裂症患者预后的影响。方法 将符合入组标准的300例农村社区精神分裂症患者分为干撷组和对照组(每组各150例)。两组均服小剂量抗精神病药(折合氯丙嗪剂量为<300 mg/d),其中干预组同时接受生物-心理-社会综合干预及个案管理;于入组时和随访每半年时评定1次社会功能缺陷筛选量表(SDSS)、简明精神病评定量表(BPRS)、疾病严重程度量表(SI)、疾病总体进步量表(GI),3年共7次。结果 (1)入组时干预组与对照组相比,BPRS、SI、GI、SDSS评分的差异均无显著性(P>0.05);(2)综合干预1年时,干预组各量表的评分均低于对照组,差异有显著性(均P<0.01),并持续到随访结束。(3)随访结束时,干预组在掌握精神卫生知识、规律就医、接受精神科治疗、恢复工作能力等方面均好于对照组(均P<0.01)。结论 生物-心理-社会综合干预使农村社区精神分裂症患者的复发率明显降低。

Effects of synthetical intervention on prognosis in rural schizophrenia

Objective To explore the availability and feasibility of bio-psycho-social intervention in the community rehabilitation of rural schizophrenia. Methods Altogether 300 rural patients with schizophrenia, who were given lower dose of antipsychotic drugs were randomly divided into intervention group and control group. Additionally, the intervention group was combined with bio-psycho-social intervention and case management. All patients were evaluated with the Social Disability Screening Schedule, Brief Psychiatric Rating Scale and Clinical Global Impressions Scale every 6 months in the 3-year follow-up study. Results At the end of the study, the patients in the intervention group showed milder illness severity, lower teratogenic and relapse rate in comparison with controls. Conclusion The synthetical bio-psycho-social intervention is effective and feasible in community rehabilitation of rural schizophrenia.