阿立哌唑与氯氮平对精神分裂症患者生活质量的影响

目的:比较阿立哌唑、氯氮平对精神分裂症患者生活质量的影响.方法:60例精神分裂症患者随机分为阿立哌唑组(30例)和氯氮平组(30例),治疗8周.应用阳性与阴性症状评定量表(PANSS)、生活质量量表(QOL)对两组治疗前后进行评定.结果:阿立哌唑与氯氮平均能明显改善患者的精神症状和生活质量.在生理、心理领域,社会关系、...     

精神分裂症患者生活质量与药物治疗态度的相关性

目的探讨精神分裂症患者生活质量与药物治疗态度的相关性。方法连续入组151例在广州市脑科医院住院的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者,分别采用健康状况量表(SF-36)、药物态度清单(DAI)、阳性和阴性症状量表(PANSS)评定其生活质量、药物治疗态度和临床症状。采用多重逐步回归分析生活质量的影响因素。结果治疗态度积极组57例,男性38例(66.7%),治疗态度消极组94例,男性40例(42.6%),积极组男性比例高于消极组;积极组SF-36心理健康维度(MCS)评分(46.8±9.1)分,消极组(41.0±10.8)分,两组比较差异有统计学意义(P0.05);多重回归分析显示患者的药物治疗态度是生活质量的影响因素(B=2.025,β=0.309,P0.05)。结论精神分裂症患者的药物治疗态度越积极,生活质量越好。     

3R健康教育对慢性精神分裂症患者竞争性就业和工作满意度的随访研究

目的研究3R健康教育对社区慢性精神分裂症患者竞争性就业以及工作满意度的长期影响。方法选取108例社区慢性精神分裂症患者,随机分为研究组(54例)和对照组(54例),对照组进行常规的随访,研究组在常规随访基础上连续进行4个月的3R健康教育,即针对精神分裂症系统的健康教育课程。社区精神科医生使用自制的竞争性就业调查表连续2年每个月随访患者竞争性就业情况,并在2年后以工作满意度量表评估患者工作满意度。结果 竞争性就业率方面,研究组和对照组在随访第6个月(21.57%vs.13.21%)、第12个月(26.00%vs.15.38%)、第18个月(24.00%vs.13.72%)、第24个月(26.53%vs.16.00%)时差异均有统计学意义(P0.05);随访第2年,竞争性就业中工作数量、工作周数、第一份工作维持时间等方面两组差异有统计学意义(P0.01);两组平均每月工资收入及工作满意度差异无统计学意义(P0.05)。结论 3R健康教育可以有效提高社区慢性精神分裂症患者在竞争性工作中的获益,值得临床上进一步应用推广。     

阿立哌唑与利培酮对血糖、血脂的影响

目的:比较阿立哌唑与利培酮对男性精神分裂症患者血糖和血脂代谢的影响.方法:将60例男性精神分裂症患者随机分为阿立哌唑组(n=30)和利培酮组(n=30),分别给以阿立哌唑和利培酮片口服,人组时和治疗8周后分别检测两组空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白和低密度脂蛋白及体质量水平和PANSS分值.结果:治疗前两组患者各项指标相比差异均无显著性(P＞0.05);治疗后利培酮组体质量增加,总胆固醇和低密度脂蛋白升高,阿立哌唑组则改变不显著.结论:阿立哌唑对男性精神分裂症血糖、血脂及体质量的影响小于利培酮.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑对精神分裂症患者生活质量的影响. 方法:将60例精神分裂症患者随机分成两组,各30例,分别给予阿立哌唑和氟哌啶醇治疗,疗程8周.用生活质量综合评定问卷(GQOLI),阳性与阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)进行评定. 结果:两组治疗后阳性症状与阴性症状均有显著改善,阿立哌唑组对生活质量改善显著优于氟哌啶醇组. 结论:阿立哌唑治疗有利于患者生活质量的提高.     

利培酮与氯氮平对精神分裂症患者生存质量影响的比较分析

鉴于提高精神分裂症患者的治疗效果及其生存质量已令人瞩目 [1]。因此,本文试图对比利培酮与氯氮平治疗对精神分裂症患者生存质量的影响及其疗效。现报道于后。1　对象与方法1 1　对象　病例选自我院 2003年 6月 ~2003年12月新入院的精神分裂症患者;均符合CCMD-3精神分裂症诊断标准;年龄为 16 ~60岁;PANSS总分≥60分;排除有严重躯体疾病,酒、药物依赖患者。本文符合上述条件者共 100例,随机分为利培酮组(50例):其中男性 12例、女性 38例,年龄 18~43岁、平均 ( 31 87±10 21 )岁,病程 2个月 ~6 5年;氯氮平组(50例 ):其中男性 21例、…     

开放式与封闭式管理对精神分裂症患者生活质量的影响

目的对比开放式与封闭式管理对首发精神分裂症患者痊愈后生活质量的影响。方法对符合ICD-10诊断标准的首发精神分裂症患者,经开放式病房(34例)、封闭式病房(32例)治疗病情痊愈出院后1月评价其生活质量。结果开放式管理组在自尊、情感、人际交往能力、工作与学习、精神紧张感等方面与封闭式管理组有显著差异。结论开放式管理有利于提高首发精神分裂症患者的生活质量。     

精神分裂症的性别差异

对精神分裂症患者的男女性别差异进行研究。1　临床资料对象为 1996年 10月～ 1999年 7月期间在我院住院 ,符合 DSM- - R与 CCMD- 2精神分裂症诊断标准患者 ,男女各 10 0例 ,进行对照分析。男女两组患者的职业、文化程度、病前性格、精神疾病家族史及发病前精神诱因等均无显著差异 (P均 >0 .0 5 )。男性已婚 2 9例 ,女性 47例 ,以女性显著较多 (P<0 .0 1)。临床分型 :男性偏执型 6 1例 ,青春型 5例 ,未分化型 16例 ;女性分别为 41、 15、 30例 ;青春型、未分化型女性明显多于男性 (P均 <0 .0 5 )。两组之间有显著差异的其它项目比较。…     

景德镇市某医院就诊精神分裂症患者生活质量调查

目的对景德镇市某医院住院和门诊精神分裂症患者的生活质量进行调查。为提高患者的生活质量,降低肇事肇祸行为的发生,使其更好地回归社会提供参考。方法采用精神分裂症病人生活质量量表(SQLS)、阳性与阴性症状量表(PANSS)、家庭环境量表(FES-CV)和社会功能缺陷量表(SDSS),对符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的520例门诊和住院精神分裂症患者进行调查。结果门诊组精神分裂症患者生活质量好、中、差者分别为29例(16.86%)、73例(42.44%)、70例(40.70%),优良率59.30%,住院组分别为44例(12.64%)、120例(34.48%)、184例(52.87%)和47.13%。两组优良率差异有统计学意义(P0.05)。门诊组SDSS、FES-CV总评分高于住院组,PANSS总评分和累计住院时间低于住院组,其中精神病性症状、生命活力、人际关系因子均高于住院组,差异均有统计学意义(P均0.05)。结论门诊精神分裂症患者生活质量高于住院患者。精神病性症状、药物副反应、社会功能损害程度、住院时间及家庭、社会环境是精神分裂症患者生活质量的重要影响因素。     

维思通与氯氮平对精神分裂症患者生活质量的影响

目的　比较维思通和氯氮平对精神分裂症患者生活质量的影响。方法　将 6 2例符合CCMD - 3标准的精神分裂症患者随机分为两组 ,分别给予维思通和氯氮平治疗 ,并随访半年 ,观察两药对患者生活质量和精神症状的影响。并以PANSS评定精神症状 ,以生活质量量表 (WHO ,QOL - 10 0 )评估生活质量 ,以TESS评定药物副反应。结果　维思通和氯氮平对精神分裂症阳性症状和阴性症状的改善相近 ;对一般精神病理症状和PANSS总分的改善前者优于后者 ;维思通比氯氮平能更好地改善患者的生活质量。结论　维思通比氯氮平能更好地改善精神分裂症的生活质量 ,有利于患者恢复社会功能 ,重返社会     

Employment predictors for discharged schizophrenia patients

Objective To investigate predictors for competitive employment in a three-year follow-up study of discharged schizophrenia patients. Methods The nationally representative sample comprised 2168 schizophrenia patients aged 15–64 years, who had been discharged from psychiatric hospitals in 1986, 1990, and 1994 in Finland. Comprehensive data were collected from psychiatric case records on the patients’ sociodemographic and clinical characteristics at discharge and use of services during the follow-up period. The patients were interviewed 3 years after discharge using a structured interview schedule, which included questions on employment. Results At follow-up, the competitive employment rate declined among the three cohorts (1989: 7.4%, 1993: 2.6% and 1997: 1.5%), whereas the rate of non-competitive employment remained at the same level (8.4%, 7.2% and 9.6%). The probability of competitive employment was higher for those who, at the time of discharge, were not on disability pension and had a current or past history of marriage, and had been discharged in the late 1980s. The probability of being competitively employed was lower for those who had no occupation at discharge and for those who had spent more time in hospital care during the three years after discharge. Conclusions The high unemployment rate and continuous changes in work life, which characterized Finland in the 1990s may have negatively affected the employment prospects of schizophrenia patients. Work rehabilitation should be more commonly offered, to increase their opportunities for obtaining competitive employment and for improving their quality of life.     

Barriers to employment for people with schizophrenia

OBJECTIVE: There is growing interest in identifying and surmounting barriers to employment for people with schizophrenia. The authors examined factors associated with participation in competitive employment or other vocational activities in a large group of patients with schizophrenia who participated in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, a multisite clinical trial comparing the effects of first- and second-generation antipsychotics. METHOD: Baseline data on more than 1,400 patients with a diagnosis of schizophrenia were collected before their entry into the CATIE study. Multinomial logistic regression was used to examine the relationship between participation in either competitive employment or other vocational activities and sociodemographic characteristics, schizophrenia symptoms, neurocognitive functioning, intrapsychic functioning, availability of psychosocial rehabilitation services, and local unemployment rates. RESULTS: Altogether, 14.5% of the patients reported participating in competitive employment in the month before the baseline assessment, 12.6% reported other (noncompetitive) employment activity, and 72.9% reported no employment activity. Participation in either competitive or noncompetitive employment was associated with having less severe symptoms, better neurocognitive functioning, and higher scores on a measure of intrapsychic functioning that encompassed motivation, empathy, and other psychological characteristics. Competitive employment, in contrast to other employment or no employment, was negatively associated with receipt of disability payments as well as with being black. Greater access to rehabilitation services was associated with greater participation in both competitive and noncompetitive employment. CONCLUSIONS: Overall employment of persons with schizophrenia seems to be impeded by clinical problems, including symptoms of schizophrenia and poorer neurocognitive and intrapsychic functioning. However, participation in competitive employment may be specifically impeded by the potentially adverse incentives of disability payments and by race and may be promoted by the availability of rehabilitation services.     

A cross-sectional study to investigate current social adjustment of offspring of patients with schizophrenia

Objective To investigate the impact of parental disorder in the life of adult offspring by evaluating education, current employment and marital status of a sample of offspring of patients with schizophrenia and comparing findings with population rates. Methods A sample of 489 patients with DSM-IV diagnoses of schizophrenia was identified in the public outpatient mental health services of the city of Cuiabá, Brazil. Of these patients, 294 had children, and a total of 828 offspring were identified. Data for 431 offspring aged 18 years or older were collected using a structured questionnaire answered by the patient-parent and a family member. Results The percentage of age-grade discrepancy for offspring aged 18 and 19 years was 59.2% (95%CI 45.4–73.0), not significantly different from the discrepancy rate for the same age group in the general population, which was 71.1%. Offspring of patients with schizophrenia had a significantly poorer employment situation than the general population (66.7% and 75.6%; 95%CI 62.1–71.3). Fewer male offspring were married than males in the general population (54.7% and 66.0%; 95%CI 48.2–61.2). Conclusion Adult offspring of patients with schizophrenia had social adjustment problems that were markedly reflected in employment and marital status. A cross-sectional study to investigate current social adjustment of offspring of patients with schizophrenia in a sample of patients from Cuiabá, Midwestern Brazil     

慢性精神分裂症患者生命质量的性别差异

目的：探讨长期住院的慢性精神分裂症患者生命质量的性别差异及影响因素。方法：采用健康状况调查问卷（SF-36）、阳性与阴性症状量表（PANSS）、治疗中出现的症状量表（TESS）对连续住院时间超过5年的72例男性、47例女性慢性精神分裂症患者进行评定,选用60名健康自愿者作为对照。结果：男性患者生命质量显菩低于女性;精神病状态、药物种类、药物不良反应、年龄、住院时间对男女生命质量均有影响;男性的生命质量还受病期、婚姻状况的影响。结论：慢性精神分裂症患者的生命质量低下．应给予更多关注。     

Neurocognitive functioning in dually diagnosed middle aged and elderly patients with alcoholism and schizophrenia

BACKGROUND: Alcohol abuse and dependence have important clinical implications for managing patients with schizophrenia. Alcoholism in schizophrenia patients can interfere with the course and prognosis of the schizophrenic illness. OBJECTIVE: The purpose of the present study was to compare the cognitive status, symptom profile and quality of life of middle aged and older patients (>44 years old) with schizophrenia and alcohol abuse/dependence vs those without alcohol abuse/dependence. We initially hypothesized that more males in this age group with schizophrenia would exhibit alcoholism. We also examined the characteristics of the 45-54 year age group with those of the > or = 55 year old group and hypothesized that comorbidity with alcohol would be associated with worse cognition and quality of life in later life. METHODS: Data were obtained from a database from the Center for Services and Interventions research at the University of California, San Diego. Patients had diagnoses of schizophrenia or schizoaffective disorder. Data collected included demographic characteristics, cognitive status (tested with the Mattis Dementia Rating Scale learning, the Figural and Story Memory Test of the Wechsler Memory Scale-Revised and the California Verbal Learning Test [CVLT]). In addition, patients had undergone psychopathologic assessment and were screened for quality of life using the Quality of Well Being scale. RESULTS: We demonstrated that the older aged patients with alcoholism had worse scores assessing cognition relative to the same aged group without alcoholism. In addition, they had worse cognitive scores relative to the younger group (45-54 year old) with alcoholism. There was no significant difference with regards to quality of life. In addition, more males than females exhibited alcoholism. CONCLUSION: The results are consistent with the premise that the higher cognitive function in the younger schizophrenia patients with alcoholism appear to mask the effects of alcohol use on cognition at that age. However, for the older group of schizophrenia patients, the effects of alcohol use on neuropsychological functioning appear to be deleterious.     

Relationship between cognition and work functioning among patients with schizophrenia in an urban area of India

OBJECTIVE: Employment rates and work functioning are poor among patients with schizophrenia and are related to cognitive dysfunction. This study examined the relationship between work functioning and cognition, other clinical and demographic variables, and measures of social functioning among patients with schizophrenia in an urban area of India. METHODS: This study evaluated cognitive dysfunction and work functioning among 88 patients with chronic schizophrenia. Attention, executive function, and memory were tested with a battery of neuropsychological tests. Work and social functions were evaluated with standardized instruments. RESULTS: Fifty-nine patients (67 percent) were employed, most in a mainstream environment. Moderate to significant work dysfunction was present among 21 patients (24 percent). When multivariate analysis was performed, cognitive deficits did not relate significantly to current employment status or to level of performance at work. Negative symptoms predicted employment status, and poor social functioning predicted poor work performance. CONCLUSIONS: The relationship between work and cognitive status in schizophrenia was not as strong as has been previously reported in this population. It was speculated that social factors, such as the compelling need to be employed, a supportive work environment, and the number of years of formal education, were factors underlying the high level of work functioning in this group despite cognitive deficits.     

To be or not to be married – that is the question of quality of life in men with schizophrenia

Background The association of gender and marital status with quality of life (QoL) was studied in a representative national sample of long-term schizophrenia patients. Methods The study sample consisted of 1,750 male and 1,506 female 15- to 64-year-old schizophrenia patients discharged from mental hospitals in 1986, 1990 and 1994 in Finland. Comprehensive data were collected from hospital and out-patient case records and the psychiatric teams carried out a structured interview regarding the patients' socio-demographic background, living places, living situation, psycho-social state and functioning and life satisfaction three years after the index discharge. Results Female patients were older, more often married, had been ill for a longer time and had moved after discharge from hospital to live alone or with their spouse more often than men. Women and married patients had migrated more often than men and single patients, but single men had more often remained living in a remote rural area than others. The QoL of single men was poorer than others in almost all the areas in which it was measured: housing conditions, working, daily functioning, number of confidants and psycho-social state. Differences between single women and married men or women were much smaller. Women, independently of their marital status, were more satisfied with their life, had more close interpersonal relationships and had done useful work more often than men. Conclusions Single male patients with schizophrenia seem to have dropped out of the development of society. They remain living in their birthplace and are more dependent than other patients. Single women migrate more consistently into urban areas, which may be favourable for their QoL. Married patients with schizophrenia, possibly partly helped by their spouse, can best follow changes in the society. Female gender also seems to have an independent association with life satisfaction and interpersonal aspects of the QoL. The results of this study strongly emphasise that the associations between gender, marital status and QoL to a great extent depend on the study sample and may also vary by study area. Accepted: 16 July 2001     

Relationships between satisfaction with occupational factors and health-related variables in schizophrenia outpatients

  Background: The purpose of this study was to explore relationships between satisfaction with occupational factors, operationalized as occupational status and the total daily occupational situation, and health-related variables among people with schizophrenia. The health-related variables included quality of life, perceived control, sense of coherence, and psychopathology. Gender differences in these relationships were explored as well. Methods: A sample of 74 individuals, aged 20–55 years, from outpatient psychiatric services were recruited to the study. A variety of interviews and self-rating scales were used in the data collection. Results: When controlling for depressive symptoms, the results showed that satisfaction with employment status was of significance for health among patients with schizophrenia, but satisfaction with the total daily occupational situation seemed to be even more important to quality of life and other health-related aspects. In particular, satisfaction with daily occupations constituted an important dimension for self-rated quality of life. Some minor sex differences could be discerned in the pattern of associations. Conclusions: The strong association between satisfaction with daily occupations and self-rated quality of life adds a new dimension to the understanding of quality of life for this group of subjects, and suggests that helping to organise an individual's daily occupations ought to be a significant task in planning for psychiatric services. Accepted: 25 September 2000     

全程干预对首发精神分裂症患者的影响

目的:探讨全程综合性干预对首发精神分裂症患者社会功能及生活质量的影响。方法:将116例首发精神分裂症患者随机分为干预组和药物组各58例,其中脱落7例。两组均接受抗精神病药治疗,干预组同时接受全程综合干预措施1年。采用简明精神病评定量表(BPRS)、住院病人护士观察量表(NOSIE-30)、社会功能缺陷量表(SDSS)和生活质量综合评定问卷(GQOLI)分别于入组时及干预结束时进行评估。结果:入组时,两组所有量表评分差异均无显著性;干预结束时,干预组的BPRS、NOSIE-30中的总消极因素及SDSS评分均明显低于药物组;而NOSIE-30总分、总积极因素及GQOLI评分均明显高于药物组。结论:全程综合性干预措施有助于改善首发精神分裂症患者的精神症状,促进其社会功能的恢复,提高其生活质量。     

Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society

Background: Employment is an important part of recovery for individuals with schizophrenia. The employment rate for this group is as low as 10% in Norway, and major system related barriers to employment are evident.

Aims: This study reports the competitive employment outcome at 2-year follow-up of a vocational rehabilitation study augmented with cognitive remediation (CR) or elements from cognitive behaviour therapy (CBT) for individuals with schizophrenia spectrum disorders. It also investigates if global functioning, self-esteem, and depression at baseline predicts employment outcome, and if change in these variables during the intervention period is associated with employment outcome.

Method: One hundred and forty-eight participants with schizophrenia spectrum disorders in six Norwegian counties received 10 months vocational rehabilitation augmented with either CBT (n?=?84) or CR (n?=?64). Both competitive and sheltered workplaces were used. Participants were assessed at baseline, at the end of the intervention period, and at 2-year follow-up.

Results: At 2-year follow-up, 21.2% had obtained competitive employment. A further 25.3% had work placements in competitive workplaces. Significant improvements were found in global functioning, self-esteem, and depression during the intervention period, but no significant differences between the two intervention groups. High baseline global functioning and self-esteem, as well as positive change in these variables during the intervention period, were significantly associated with higher competitive employment outcome at 2-year follow-up.

Conclusion: The results add to existing evidence that competitive employment is attainable for individuals with schizophrenia. High global functioning and self-esteem were strongly associated with competitive employment outcome.