社区个体化干预对精神分裂症的康复作用

目的探索社区个体化干预对精神分裂症康复效果的有效途径。方法采用随机抽样法，对50例精神分裂症患者进行为期二年的社区个体化干预，并设50例对照组。社会功能缺陷筛选量表、Morning Side康复状态量表评估患者的康复情况。结果干预组患者复发8例，复发比例16％；对照组复发20例，复发比例40％，两组差异有统计学意义（，=53．65，P〈0．01）。干预组患者的社会功能缺陷筛选量表总分和Morning Side康复状态量表各项分数也优于对照组。结论社区个体化干预对精神分裂症患者的康复是有效方法之一。     

精神分裂症的社区干预

报道１０２例精神分裂症社区干预为期３年的随机对照研究，研究对象分为研究组５２例，对照组５０例。使用的评价工具包括ＳＤＳＳ、ＧＡＳ及自编的病情现状和对社会影响调查表。研究结果显示：研究组在社会功能缺陷、ＧＡＳ评分、病情现状及对社会影响校对照组有较显著的改善（Ｐ＜０．０５～０．００１），研究组自身比较在几乎全部评定项目的评分差异上有显著的统计学意义。本文并介绍了开展社区干预的工作方法。     

精神分裂症主动式社区干预的研究进展

精神分裂症的社区康复对患者正常生活和回归社会的作用越来越受到人们的重视，主动 式社区干预作为一种在国际上被广泛认可和应用的服务模式，对我国社区精神卫生服务的发展具有较 高的参考价值。现对国内外主动式社区干预对精神分裂症康复作用的研究进行综述。     

精神卫生综合干预对社区精神分裂症患者的康复作用

目的:探讨精神卫生综合干预对社区精神分裂症患者的康复作用。方法:将精神病患者日间康复照料机构中的89例精神分裂症康复期患者随机分为干预组和对照组;在接受常规社区精神卫生服务的同时,给予干预组精神卫生综合干预(健康教育、家庭治疗及技能程式训练)1年。分别在入组时、干预3、6、9及12个月进行阳性和阴性症状量表(PANSS)、康复状态量表(MRSS)和社会功能缺陷筛选量表(SDSS)评定。结果:PANSS阴性症状分和一般病理分具有组间效应(F=2175.79;P0.001;F=4.74,P0.05);两组PANSS总分、阴性症状分和一般病理分具有时间效应(F=29.32、23.07、15.21,P均0.001)及交互作用(F=3.27,P0.05;F=6.06,P0.001;F=3.55,P0.01)。两组MRSS总分、活动能力缺乏、社交能力、目前症状和异常行为评分具有时间效应(F=14.53、12.74、8.58、6.26;P均0.001)及交互作用(F=6.34,P0.001;F=2.47,P0.05;F=8.58,P0.001;F=2.88,P0.05)。两组SDSS评分具有时间效应和具有交互作用(F=10.69,F=5.19;P均0.001)。两组康复状况比较差异无统计学意义。结论:精神卫生综合干预对改善精神分裂症患者状况及提高社交技能方面优于常规社区精神卫生服务。     

社区家庭干预对精神分裂症患得及家属的作用

本文系前瞻性对照研究，对上海市区两个街道的１２０例精神分裂症患者进行家庭干预的对照研究。结果提示，实施家庭干预结合家庭教育，对社区的精神病患者确能起到缓解病情，减少复发，提高社会功能及促进康复的作用。     

社区家庭干预对精神分裂症患者及家属的作用

本文系前瞻性对照研究，对上海市区两个街道的120例精神分裂症患者进行家庭干预的对照研究。结果提示，实施家庭干预结合家庭教育，对社区的精神病患者确能起到缓解病情，减少复发，提高社会功能及促进康复的作用。     

早期干预对首发精神分裂症患者的影响

目的：探讨早期干预对首发精神分裂症患者疗效和社会功能康复的影响。方法：干预组为50例首发精神分裂症患者，在药物治疗同时辅以心理和社会综合干预措施，50例与之匹配的对照患者单用药物治疗。采用阳性症状和阴性症状量表(PANSS)及社会功能缺陷筛选量表(SDSS)分别进行随访评定。结果：干预组随访时PANSS阴性量表分的改善明显优于对照组；SDSS的职业和工作、家庭外社会活动、家庭职能、个人生活自理、责任性和计划性5项因子分的改善明显优于对照组。结论：早期干预措施有助于提高精神分裂症患者的疗效和促进社会功能的康复。     

社区干预对精神分裂症患者的作用

目的：探索主动性社区干预的康复治疗方法对社区精神分裂症患者的作用。方法：精神分裂症128例,连续1年的主动性访视干预社区治疗康复效果。结果：在维持药物治疗的基础上,主动性访视干预1年后精神分裂症患者的简明精神病评定量表（BPRS）各因子、临床疗效总评量表（CGI）评分下降有显著性,世界卫生组织生活质量简表（WHOQOL-BREF）各因子自我评分和总体生活质量评分均高于1年前。结论：主动性访视干预康复对精神分裂症患者有效。     

社区康复联合药物治疗对农村社区精神分裂症患者康复的效果

目的 研究社区康复联合药物治疗对农村社区精神分裂症患者康复的效果,为我国农村地区精神分裂症患者社区康复提供参考.方法 选择兰州新区三个镇农村社区中符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者81例,按随机数字表法分为研究组(n=39)和对照组(n=42),两组均接受一般药物治疗,研究组在此基...     

综合干预对社区精神分裂症的疗效观察

目的探讨生物、心理、社会综合干预对精神分裂症患者的疗效。方法对干预组除常规药物治疗外，加强了集体、个别心理治疗、家庭教育和社会支持力度，并随访两年，且与对照组相比较。结果研究发现社区精神分裂症患者经过综合干预后，取得了明显效果，复发再住院者2例(4，9％)，而没有实施综合干预的对照组，复发再住院12例(25％)。结论对社区精神分裂症患者进行上述干预，可以促进其心理康复，减少疾病复发。     

Early detection and intervention in first-episode schizophrenia: a critical review

OBJECTIVE: To review the literature on early intervention in psychosis and to evaluate relevant studies. Method: Early intervention was defined as intervention in the prodromal phase (primary prevention) and intervention after the onset of psychosis, i.e. shortening of duration of untreated psychosis (DUP) (secondary prevention). RESULTS: We found few studies aimed at early intervention, but many papers discussing the idea at a more general level. We identified no studies that prove that intervention in the prodromal phase is possible without a high risk for treating false positives. We identified some studies aimed at reducing DUP, but the results are ambiguous and, until now, no follow-up data showing a positive effect on prognosis have been presented. CONCLUSION: Early intervention in psychosis is a difficult and important challenge for the psychiatric health services. At the time being reduction of DUP seems to be the most promising strategy. Intervention in the prodromal phase is more ethically and conceptually problematic.     

Training patients with schizophrenia with the community re-entry module

Background There is increasing evidence indicating that the Community Re-entry Module (CRM), a brief, structured instrument, could guide an effective intervention for patients with schizophrenia. This study evaluated the effectiveness of the Chinese version of the CRM with respect to improvement in psychiatric symptoms, social functioning as well as relapse and re-hospitalization rates in comparison with a supportive counseling (SC) intervention. Method Ninety-six outpatients with DSM-IV schizophrenia were randomly allocated to either CRM (N=48) or an equally intensive intervention of SC (N=48). The CRM was composed of 16 one-hour sessions, which were conducted with groups of 6–8 patients on a twice-a-week schedule. The two groups received routine psychiatric outpatient care during the intervention. Participants were assessed on an intention-to-treat basis with the Positive and Negative Syndrome Scales (PANSS), with the Social Disability Screening Schedule (SDSS) by two independent raters before and immediately after intervention, and at 6-month follow-up. The number of relapse and re-hospitalization were also documented. Results The CRM group significantly improved in terms of psychiatric symptoms and social functioning compared with the SC group. Rates of relapse and re-hospitalization in the CRM group were lower although the difference between the two groups was not statistically significant. Conclusions The study supports the feasibility and effectiveness of the Chinese version of the CRM as an effective psychosocial intervention for Chinese patients with schizophrenia to improve psychopathology, social functioning and relapse and re-hospitalization rates.     

心理干预对精神分裂症患者亲属心理状况的影响

目的：探讨心理干预对精神分裂症患者亲属心理状况的影响。方法：采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和自编精神分裂症健康知识调查问卷对83名精神分裂症患者的亲属进行调查,并对其进行为期4周的心理干预。结果：精神分裂症患者亲属心理干预前的SAS和SDS评分分别为（53.90±2.02）分和（61.40±1.07）分,显著高于全国常模的（41.90±2.60）分和（41.40±1.83）分（P〈0.05）;心理干预后患者亲属的SAS和SDS评分分别为（41.00±1.56）分和（41.50±1.08）分,较干预前有显著降低（P〈0.05）;干预后亲属对患者疾病相关知识的知晓度明显提高。结论：心理干预可有效改善患者亲属的心理状况。     

Long-term effects of a community intervention for early identification of first-episode psychosis

Objective: To assess whether an Early Case Identification Program (ECIP) for first‐episode psychosis (FEP), which showed no significant short‐term effects, has a delayed impact on duration of untreated psychosis (DUP). Method: Using a historical control design, FEP patients were assessed on clinical variables over three consecutive phases, 2 years prior, 2 years during and 3 years after implementation of the ECIP. Additional analyses were conducted on non‐affective and schizophrenia spectrum psychoses cases only. Results: There was no overall significant difference in DUP across the three phases. For cases treated within the first year of illness a nonsignificant reduction in DUP to less than 2 months observed during the active phase was sustained post‐ECIP. Conclusion: In some jurisdictions community‐wide early case detection may fail to have an immediate or delayed effect on DUP, especially for cases who normally present for treatment with DUP >1 year.     

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。     

The effects of childhood trauma in patients with first-episode schizophrenia

OBJECTIVE: To evaluate the impact of childhood trauma on psychopathology in 57 patients with first-episode schizophrenia. METHOD: Psychopathology was assessed by Brief Psychiatric Research Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) at first admission. Childhood trauma was assessed by Childhood Abuse Questionnaire and Childhood Trauma Questionnaire (CTQ) after discharge. RESULTS: Frequencies of childhood sexual abuse (CSA), emotional abuse (CEA) and physical abuse (CPA) were reported by 29.8%, 40.9% and 13.6% of the patients respectively. Histories of childhood emotional neglect (CEN) and physical neglect were found in 29.5% and 20.5% of the patients respectively. The patients reporting CSA had higher SAPS scores at admission, and had more suicide attempts before admission. The patients with history of CEA had more hallucinations and delusions of mind reading at admission. CPA, CEA and mean scores of CTQ correlated with the number of siblings. CONCLUSION: Our findings suggest that childhood trauma may alter the presentation of schizophrenia in first admission.     

对中小城市社区精神分裂症患者的现状分析

目的为了解社区精神分裂症患者的现状及其特点。方法对两个市第一次社区康复工作所得资料进行了比较分析。结果两市患者的年龄、婚姻、起病形式、病前性格、家族史、疾病分型、社会影响及治疗情况均无显著性差异；而在文化程度、职业、家庭经济、起病年龄、起病诱因、胎次、病程、是否曾接受专科门诊和住院、现状、社会功能等方面则有显著性差异；经多元逐步回归分析显示，影响两市患者疗效最主要的是家人对患者的态度和既往治疗情况。本文提示，不同社会环境对社区中精神分裂症患者的现状产生了不同的影响