日间康复站康复模式对精神分裂症患者康复效果的评价

目的：探讨日间康复站康复模式对精神分裂症患者的康复效果。方法：200例社区精神分裂症患者随机分成康复组和对照组各100例,康复组在药物治疗基础上参加日间康复站的综合康复训练,对照组仅接受常规药物治疗。采用阳性与阴性症状量表（ PANSS）、个人与社会表现量表（ PSP）在康复前和康复后3、6个月,对两组疗效和社会功能改善情况进行评估比较。结果：康复6个月,康复组PANSS总分、阴性症状分低于对照组（P均<0.01）;PSP总分高于对照组（P<0.01）。重复测量方差分析,两组PANSS总分、阳性症状分、阴性症状分、一般精神病理分和PSP总分在时间效应上有统计学意义（F=18.965,F=4.265,F=30.189,F=21.988,F=18.620;P<0.05或P<0.01）;PANSS总分、阴性症状分、一般精神病理分和PSP总分在交互效应上有统计学意义（ F=16.398,F=17.237,F=3.734, F=19.937;P<0.05或P<0.01）。结论：精神分裂症患者在日间康复站的系统综合康复训练可明显减轻精神症状;改善社会功能,增强回归社会的能力。     

家庭干预对社区精神分裂症患者社会功能及残疾康复作用的研究

近年来,WHO倡导的社区为基础的康复(CBR),是促进精神分裂症患者在社区中的康复以及发展的新的康复措施,同时亦探讨家庭教育这一干预措施对精神分裂症患者社会功能康复,降低致残率方面的作用,我们于1991年5月～1992年7月对济南市125例社区中精神分裂症患者亲属(主要照料者)进行了家庭教育前瞻性对照研究,现将结果分析报导如下:     

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。     

不同社区康复模式对稳定期精神分裂症患者的康复效果比较

目的:探讨居家康复、社区综合康复和日间机构康复3种不同社区康复模式对稳定期精神分裂症患者康复效果的影响.方法:选取社区稳定期精神分裂症患者200例,随机分成综合组、居家组各100例,在社区日间康复中心随机选取精神分裂症患者100例,构成机构组.居家组接受常规随访服务和康复指导,综合组接受团队综合干预服务,机构组在社区日...     

支持性心理干预联合社区日间康复训练对慢性精神分裂症患者的远期疗效

目的探讨支持性心理干预联合社区日间康复训练对慢性精神分裂症患者的远期康复疗效。方法 2011年10月至2012年9月选取慢性精神分裂症患者,按照随机抽样方法,入选样本84例,随机分为两组:干预组和对照组,每组42例。干预组接受支持性心理干预和社区日间康复干预6个月,对照组按社区常规随访6月。12个月末采用采用阳性与阴性症状量表(PANSS)、康复量表(MRSS)、自知力与态度问卷调查(ITAQ)、复发率和再住院率评估两组的康复疗效。结果干预组、对照组患者入组时PANSS、MRSS以及ITAQ评分差异无统计学意义(P0.05)。干预后干预组的PANSS总分及阴性量表分显著低于对照组,差异有显著性(P0.05)、MRSS总分及依赖性、活动能力、社交能力较对照组下降,ITAQ评分显著高于对照组,差异有显著性(P0.05),症状行为因子分两组无差异(P0.05)。干预组复发率及再住院率显著低于对照组(P0.05),差异具有统计学意义。结论支持性心理干预联合社区日间康复能更好地改善慢性精神分裂症患者的症状、提高其自知力,降低复发率和再住院率,对促进其康复水平有积极意义。     

工娱治疗对慢性精神分裂症患者社会功能康复的作用

慢性精神分裂症患者的社会功能康复是精神卫生工作者研究的重要课题之一。为此,本文探讨了工娱治疗对慢性精神分裂症患者的社会康复作用,现将结果报告如下：     

医院内分级康复对慢性精神分裂症患者疗效的对照研究

为探索医院内分级康复对慢性精神分裂症患者的疗效和方法，进行如下研究。     

健康教育对精神分裂症患者的康复作用

目的:探讨健康教育对恢复期精神分裂症患者康复的作用.方法:108例精神分裂症患者随机分成观察组54例和对照组54例,观察组在接受常规治疗护理的同时再接受健康教育,对照组接受常规的护理;在入组及入组后2周、4周给予护士用简明精神病量表(N-BPRS)进行评定.结果:接受健康教育护理的观察组患者N-BPRS总分在观察2周和...     

家庭教育对精神分裂症患者社区康复作用的对照研究

对４０８例回归社区的精神分裂患者的主要照顾者进行了为期１年的有关精神病防治知识的家庭教育（教育组），并设２１０例未接受教育者为对照组。结果：教育患者复发率降低了２４％，对照组仅降低了５％，教育组患者社会功能和家庭负担量表的减分率分别为：２５％和４４％，明显高于对照组的１％和９％。教育组患者的疗效水平，服药依从性和就诊合程度均优对照组。家庭教育简便，易行，有效，便于推广应用。     

职业康复对慢性精神分裂症患者症状及功能的影响

目的 探讨职业康复对慢性精神分裂症患者症状及功能的影响.方法 将102例慢性精神分裂症住院患者随机分为研究组和对照组各51例,其中脱落15例.两组患者均开展药物治疗、简单工娱治疗,研究组增加职业康复训练项目.采用阳性与阴性症状量表(PANSS )和Morning Side康复状态量表(MRSS )分别于入组时、中期、结束对两组患者进行评定,疗程6个月.结果 研究组PANSS总分、阳性症状分、阴性症状分及一般精神病理量表分减分值均大于时照组(P <0.01);研究组MRSS总分、依赖量表分、活动能力量表分、社交量表分、症状量表分减分值均大于对照组(P <0.01).结论 职业康复训练能更加有效改善患者的精神症状、社会功能缺陷程度,减缓精神衰退,进而实现疾病及功能的全面康复.     

Evaluating the effects of brief day hospital closure

The wellbeing of attenders of an old age psychiatry day hospital and their carers was assessed as the unit closed over a 2-week period. Decline in the wellbeing of carers and attenders was seen with a regression to preclosure levels. The results suggest the importance of the day hospital to the patients and their carers. The problems of evaluation at short notice are discussed.     

精神分裂症认知功能障碍功能磁共振成像研究的进展

精神分裂症是一种使人类严重丧失社会生活功能的疾病,影响了1%的世界人口,发病率和死亡率较高[1-2].精神分裂症通常发生在青春期或成年早期,约70%转为慢性精神分裂症[3].精神分裂症患者存在严重的认知功能障碍,疾病改变了患者的大脑结构和功能,对人的思维、注意力和协调性方面有很大影响[4],主要表现在注意、记忆和执行功能等方面[5].随着神经功能影像学的发展,很多功能影像相关的技术成为研究精神分裂症的重要方法.最初,科学家们利用功能影像学研究精神分裂症认知功能障碍与大脑各个脑功能区域的联系,试图通过建立多个脑区之间广泛地功能连接来更好地解释精神分裂症患者混乱的认知功能.功能磁共振成像(Functional Magnetic Resonance Imaging,fMRI)作为一种比较成熟的功能影像技术,广泛地被科研人员应用于精神分裂症患者认知功能损害的研究中,并取得了一定成果.这些成果为我们提供了对精神分裂患者的大脑进行更细微研究的一些理解,现将研究进展综述如下.     

Self-assessment of functional status in schizophrenia

With new treatments targeting features of schizophrenia associated with functional disability, there is a need to evaluate the validity of ratings of everyday outcomes. It is unknown whether patients can validly self-report on aspects of their functional status, which would be a potentially economical method for obtaining outcome data. In this study, 67 older schizophrenia outpatients provided self-ratings of everyday real-world functioning using the specific levels of functioning scale (SLOF). They were also administered assessments of neuropsychological performance, performance-based measures of functional capacity and social skills, clinical symptoms, and quality of life. Case managers, unaware of other ratings, also generated SLOF ratings. Based on discrepancy scores, participants were categorized as accurate raters (n = 24), underestimators (n = 16), or overestimators (n = 27) of their functional status as compared to case managers’ ratings. Patients’ self-rated functional status was correlated with their subjective quality of life, but remarkably unassociated with case manager ratings of functional status or their own performance on functional capacity or social skills measures. Case manager ratings, however, were highly correlated with performance on functional capacity and social skills measures. Patients who underestimated their real world performance had better cognitive skills and greater self-rated depression than those who overestimated. Accurate raters demonstrated greater social skills than both overestimators and underestimators, while overestimators were most cognitively and functionally impaired. Accurate ratings of everyday outcomes in schizophrenia may require systematic observation of real world outcomes or performance-based measures, as self-reports were inconsistent with objective information.     

The day hospital in old age psychiatry: The case against

The day hospital in old age psychiatry has many supporters and is widely felt to be la ‘good thing’. This article suggests there is an opposing view and that more hard data are required before the argument is resolved. Other models of care are mentioned which may be equally valid—comparison between different models is needed.     

Visual hallucinations in schizophrenia investigated with functional magnetic resonance imaging

We investigated a 27-year old patient with paranoid schizophrenia. Brain activity related to visual hallucinations was found in higher visual areas corresponding to the content of the hallucinations (faces, bodies, scenes) and the hippocampus. We assume that the hippocampal activity is related to the retrieval of visual images from memory and that sensory cortex activity is related to the vividness of the perceptual experience.     

Genetic and functional study of the IPO5 gene in schizophrenia

The present work reported on a weak association of the importin 5 (IPO5) gene with schizophrenia in combined family and case-control samples and also investigated a possible mechanism by which the IPO5 gene may contribute to the development of the disease in a Chinese population. Our results suggest that abnormal expression and alternative splicing of the IPO5 gene may be involved in the pathophysiology of schizophrenia.     

早期综合康复对脑出血术后瘫痪肢体功能恢复的作用

目的探讨早期综合康复对脑出血术后瘫痪肢体功能恢复的作用。方法对34例脑出血术后患者分组治疗护理,治疗组除常规药物治疗外,应用主、被动疗法,针灸、高压氧疗方法,并于3~4周进行肢体功能评定。结果治疗组肌力恢复有效率明显高于对照组,FMA和ADL评分明显高于对照组,2组比较差异有统计学意义(P<0.05)。结论早期综合康复能有效促进脑出血术后瘫痪肢体功能的恢复。     

Combining day patient treatment with family work in a child psychiatry clinic

Summary The 81 youngsters who began attending a day treatment programme within a 1-year period were assessed using an interval design. The children ranged in age from 18 months to 16 years and attended with similarly aged children for 1 day a week. The treatment programme combined family therapy with the day unit's milieu therapy and specific individual treatment programmes for the child. The results indicate that the combination of a 1 day a week attendance and family therapy had a significant clinical impact upon the problems. The pattern of improvement observed would suggest that the day-unit attendance made a unique contribution to the overall outcome.