精神分裂症恢复期的家庭治疗

对精神分裂症患者恢复期的家庭治疗作一简述。     

精神药物对精神分裂症患者生活质量的影响

目的：比较利培酮与舒必利对精神分裂症患者生活质量、精神症状和效果指数的影响。方法：对精神分裂症患者使用利培酮或舒必利治疗，随访6个月，观察药物对患者的生活质量、精神症状和效果指数的影响。结果：6个月观察发现，利培酮对患者生活质量的影响，除生理领域、精神支柱外均明显地提高；舒必利仅明显改善心理领域，但降低患者的生活质量总评。利培酮对患者的生活质量总评，生理领域，心理领域，独立性领域，社会关系领域和环境领域明显优越于舒必利；利培酮对患者阳性症状与阴性症状量表所有项目的改善亦均明显优于舒必利。利培酮的效果指数优于舒必利。结论：利培酮比舒必利更有利于改善精神分裂症患者的生活质量，有利于患者重返社会。     

家庭治疗对精神分裂症复发率影响的对照研究

目的探讨家庭治疗对精神分裂症病人复发率的影响。方法将符合CCMD-3精神分裂症诊断标准初次住院并痊愈出院的60例男病人随机分为两组,对A组的30例精神分裂症病人不进行家庭治疗,而B组的30例精神分裂症病人进行家庭治疗,两个疗程后随访两年,应用CCMD-3的精神分裂症诊断标准对两组病人进行是否复发的诊断。结果A组病人的复发率(73.33%)明显高于B组(16.67%),差异具统计学意义(χ2=19.46,P<0.05)。结论家庭治疗可以相应地减少精神分裂症病人的复发率。     

家庭治疗对精神分裂症患者的疗效及家庭功能的影响

目的评估家庭治疗对门诊精神分裂症患者的治疗效果及对家庭功能的影响。方法将符合ICD-10精神分裂症诊断标准病情缓解期的门诊患者82例分为2组,分别为治疗组(42例)与对照组(40例),治疗组予以开展家庭治疗联合常规药物治疗,对照组则单用常规药物治疗,治疗观察为期1年,分别于治疗前,治疗6月及12月末采用阳性与阴性症状量表(PANSS)、临床总体印象量表(CGI)及家庭功能量表(FAD)评定患者精神症状及家庭功能。结果 (1)与治疗前比较,研究组12月末PANSS、CGI、FAD总分及各因子分均有显著差异(P0.001),而对照组治疗前后无差异;(2)与对照组比较,研究组治疗12月末PANSS、CGI、FAD总分及各因子分均有显著差异(P0.001)。结论家庭治疗能有效改善精神分裂症患者精神症状及家庭功能。     

森田疗法对精神分裂症患者生活质量的影响

目的：观察森田疗法对长期住院精神分裂症患者辅助治疗作用以及对生活质量的影响；方法：对100例精神分裂症患者平分成森田组和对照组，治疗8周，分别以生活质量量表(QOLS)、住院精神病人康复疗效量表(IPROS)、阴性症状量表(SANS)等评定疗效；结果：森田组治疗前、治疗后QOLS、IPROS、SANS自身比较有显著差异；各种量表的减分率两组有显著差异：结论：森田疗法对长期住院精神分裂症病人能改善阴性症状，并能提高康复水平及生活质量。     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氯氮平对精神分裂症患者生活质量的影响。方法：对门诊72例服用利培酮及74例服用氯氮平的精神分裂症患者用自制精神分裂症患者生活质量调查表、阳性症状及阴性症状量表(PANSS)及不良反应症状量表(TESS)进行调查，并与某些因素进行多元逐步回归分析。结果：氯氮平组患者的客观及主观生活质量均较利培酮组差。结论：从消耗／效果分析，利培酮明显优于氯氮平，更有利于患者适应社会。     

精神分裂症患者的生活质量

本文就精神分裂症患者的生活质量评估现状及有关心理干预作一综述.     

“一站式”社区系统家庭治疗模式对精神分裂症康复效果分析

目的探讨"一站式"社区系统家庭治疗模式对精神分裂症患者家庭环境和自测健康状况的影响。方法将病情处于缓解期的精神分裂症患者120例分为研究组和对照组各60例,两组病例均维持抗精神病药物治疗和一般性健康教育,研究组在"社区工疗站"定期接受系统家庭治疗,对照组不参与"社区工疗站"活动。采用阳性和阴性症状量表(PANSS)、自测健康评定量表(SRHMS)、家庭环境量表中文版(FES-CV)在治疗前及治疗两年后对两组患者进行评定。结果治疗后研究组和对照组PANSS评分、SRHMS总评分差异均有统计学意义[(50.01±13.93)分vs.(78.59±14.88)分,(339.97±41.86)分vs.(290.46±41.84)分,P均0.01]。结论 "一站式"社区系统家庭治疗可能有助于稳定精神分裂症患者的病情,减少复发,提高患者的健康自测水平。     

利培酮对精神分裂症患者生活质量的影响

目的探讨利培酮与氯氮平对精神分裂症患生活质量的影响。方法将符合CCMD-3精神分裂症诊断标准的患,随机分为两组,应用利培酮与氯氮平治疗,疗程为12周。采用PANSS评定疗效,用ESRS评定锥体外系症状、TESS评定其他不良反应,以GQOLI评定生活质量。结果利培酮组的疗效明显优于氯氮平组,且无明显不良反应。利培酮组的躯体健康维度、心理健康维度及社会功能维度分均高于氯氮平组,有显性差异。结论利培酮对精神分裂症有显的疗效,患的依从性好,生活质量优于氯氮平。     

北京城区精神分裂症家属经济负担与生存质量

目的：了解精神分裂症家属的经济负担与生存质量的关系。方法：对来自北京市东城区的172位社区精神分裂症家属进行了一般资料,疾病家庭负担量表及世界卫生组织生存质量测定量表简表的调查,对经济负担和生存质量进行相关性分析,并按照不同医疗付费方式进行分组,比较各组间经济负担和生存质量的差异。结果：精神分裂症家属经济负担评分与生存质量总分、生理领域、环境领域评分呈负相关（P〈0.01）;自费医疗比公费医疗经济负担大（P〈0.05）;不同医疗付费方式的精神分裂症家属生存质量总分及其4个领域总体差异无显著性（P〉0.05）。结论：社区精神分裂症家属的经济负担越重,生存质量越低,应采取相应干预措施提高精神分裂症患者家属的生存质量。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。     

Depression and subjective quality of life in chronic phase schizophrenic patients

OBJECTIVE: To evaluate the influence of depression on subjective quality of life in schizophrenic patients. METHOD: Sixty-seven schizophrenic patients in a stabilized phase were included. Schizophrenic symptoms were evaluated using the Positive and Negative Symptoms Scale (PANSS). The subjective quality of life was evaluated using the short version of the Lehman quality of life scale (QoLI). Depression was evaluated using the Calgary Depression Scale for Schizophrenia (CDSS) and extrapyramidal effects with the Extrapyramidal Symptoms Rating Scale (ESRS). RESULTS: The PANSS total score, PANSS general psychopathology subscore, PANSS depression factor, the total CDSS and some ESRS scores were negatively correlated with the overall life satisfaction score. The CDSS score was negatively correlated with all except one QoLI score. QoLI scores were significantly lower in depressed patients, and this result remained consistent for four QoLi dimensions when adjusted on ESRS and PANSS scores. When analysing the association between high depression scores and high parkinsonism scores with reduced quality of life, multivariate analysis showed that depression was the main explanatory factor: the CDSS total score explained 22% of the variance of the overall subjective quality of life score. The patient questionnaire at the ESRS explained 10.5% of the variance of the 'mental and physical health' QoLI score. CONCLUSION: In schizophrenic patients, depressive symptoms should be focused because of their strong association to overall subjective quality of life.     

抑郁症患者家属生活质量调查

目的：了解抑郁症患者家属的生活质量。方法：应用生活质量综合评定问卷对116名抑郁症患者家属及52名正常对照者进行评定。结果：抑郁症患者家属的总体生活质量及躯体功能、心理功能、社会功能、物质生活较正常对照者差,其中以心理健康和躯体健康对生活质量的影响最大。结论：抑郁症患者家属的生活质量较正常对照者差,并涉及到心身健康的多个方面。     

奎硫平与奥氮平对精神分裂症患者生活质量的影响

目的：观察奎硫平与奥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奎硫平组和奥氮平组,各30例。分别给予奎硫平和奥氮平治疗12周。采用阳性与阴性症状量表（PANSS）、生活质量综合评定问卷（GQOLI）及治疗中出现的症状量表（TESS）评定疗效及不良反应。结果：治疗后两组PANSS总分均明显下降（P〈0.01）;奎硫平组GQOLI总分及躯体健康维度中的躯体不适感、食与性功能、运动与感觉因子分均较治疗前显著增高（P均〈0.01）,与奥氮平组比较差异有统计学意义（P〈0.01）。两组TESS评分以奎硫平组（3.1±1.7）分明显低于奥氮平组（8.1±3.9）分（P〈0.01）。结论：奎硫平治疗精神分裂症疗效与奥氮平相仿,但更能提高患者的生活质量。     

精神分裂症患者的生活质量——缓解期偏执型精神分裂症患者生活质量调查

目的：调查缓解期偏执型精神分裂症患者的生活质量。方法：采用生活质量综合评定问卷（CQOLI-74）、简明精神病评定量表（BPRS）和治疗中出现的症状量表（TESS）了解患者的生活质量、精神状态、药物不良反应对生活质量的影响。结果：患者组的生活质量总分、躯体功能、心理功能、社会功能明显低于对照组，并涉及到心身健康的多个方面。BPRS分与生活质量呈负相关。结论：缓解期偏执型精神分裂症患者的生活质量明显低于正常人群。     

Individual quality of life in schizophrenic patients – description and applicability of GRIDQoL in a computer‐based version

The measurement of individual quality of life in patients with schizophrenia has been limited to clinician‐rated instruments. The repertory grid is a clinician‐assisted method to measure individual quality of life that has been found to be more sensitive than questionnaires in a clinical trial with patients with anxiety. In this pilot study the applicability of the GRIDQoL repertory grid method was evaluated in patients with schizophrenia. Free personal constructs were elicited at the first visit using the GRIDQoL technique, a semi‐structured interview technique whereby the clinician helps the patient to develop his or her personal quality of life scale. The fixed psychological constructs were based on the PCASEE index. The results showed that the PCASEE index was adequate with respect to the fixed GRIDQoL constructs. The free constructs were illustrated for a selected patient, including the factor scores as outcome measures. In total 73% of the patients, who fulfilled the inclusion criteria, were willing and able to test their quality of life. The results of this pilot study support further development of the GRIDQoL module for schizophrenic patients. Copyright © 2001 Whurr Publishers Ltd.     

Social integration and the quality of life of schizophrenic patients in different types of complementary care

Following reunification in Germany in 1990 the new states in the Federal Republic faced the task of restructuring and rebuilding the structures of complementary care for the chronically mentally ill. First and foremost, residential facilities had to be established that would correspond to and meet the currently high need for de-hospitalization by making different types of care and care concepts available. Five groups of patients with chronic schizophrenic psychoses (N = 245 patients) who live in different types of psychiatric care facilities (psychiatric nursing home, social therapeutic hostel, sheltered community residence) or at home, either with or without a family network, were studied. In addition to the sociodemographic data, the psychopathology and the extent of social disabilities were also surveyed, as well as data on the living situation and the subjective quality of life with an emphasis on 'social relationships', 'recreation/leisure activities', and 'general independence'. The five groups differed with regard to various sociodemographic and disorder-related variables, particularly with regard to the extent of social disabilities. Especially relevant, however, are the differences among the patient groups in the extent of daily social life and recreational/leisure activities that are partially reflected in their statements on the subjective quality of life. Primarily for the two groups of home residents, but also in part for the patients living in sheltered community care, social contacts are more or less limited to the residential situation and patients are more or less otherwise socially isolated. This is due among other things to the fact that patients who have been hospitalized for long periods do not as a rule return to their prior area of residence; thus, the available compensatory mediation of relationships with the social environment does not suffice. Demands for the further development of complementary systems of psychiatric care derive from these findings.     

奎硫平对精神分裂症患者生活质量的影响

目的：比较奎硫平与氯丙嗪对精神分裂症患者生活质量的影响。方法：采用生活质量问卷(QOL)、阳性与阴性症状量表(PANSS)、副反应量表(TESS)、健康状况问卷(SF-36)进行疗效、不良反应和生活质量评估,并对影响生活质量的某些因素进行多元逐步回归分析。结果：两组PANSS评分治疗前后均有极显著差异,而两组同期相比差异则无显著性。治疗结束后,奎硫平组在生理机能、生理职能、生活活力、社会功能4个因子分及生存质量总评分均明显高于氯丙嗪组。多因素逐步回归分析显示影响患者生存质量的主要因素依次为精神症状、药物、不良反应、病程。结论：奎硫平与氯丙嗪对精神分裂症疗效相当,生活质量影响优于氯丙嗪。     

Subjective experience of treatment,side-effects,mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics

Larsen EB, Gerlach J. Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics. Acta Psychiatr Scand 1996: 93: 381–388. © Munksgaard 1996. Attitude towards treatment, side-effects, mental state and quality of life was assessed in 53 chronic schizophrenic out-patients on maintenance treatment with depot neuroleptics. It was found that 60% of the patients viewed depot medication positively, while only 8% viewed it negatively. Only 70% of patients complained about side-effects, even though 94% had scored as having them. Hypokinesia and hyperkinesis were the side-effects least noticed by the patients, but most noticed by the treating physician, while the opposite was the case with psychic side-effects. Only 49% of patients thought they had a psychotic illness, and there was no correlation between the patients' own evaluation of the severity of their illness and their score on the Positive and Negative Symptom Scale (PANSS) or the treating physician's evaluation. Quality of life did not correlate with either side-effect score or PANSS score. The schizophrenic patients' assessment of their condition was therefore in general different both from that of the treating physician and from that determined using rating scales.