DUP和家庭功能对首发精神分裂症患者1年内复发的影响研究

目的 研究未治疗精神病期(duration of unmediacted psychsis,DUP)和家庭功能等因素对首发精神分裂症患者1年内复发的影响.方法 调查经临床治愈的首发精神分裂症患者的DUP及其家庭功能,同时随访患者在接受治疗1年间的复发时间及治疗前后的精神症状.使用家庭关怀度指数量表(APGAR)评定患者的家庭功能情况,应用简明精神病评定表(BPRS)和阳性与阴性症状量表(PANSS)评定精神症状.根据患者1年内的复发情况,分为复发组和未复发组进行比较.结果 (1)共入组95例患者,其中87例完成1年随访,有34例在1年中复发.复发组的DUP明显长于未复发组(4.59±3.79)月 vs (3.12±1.78)月,t=2.121,P=0.04;(2)复发组患者随访1年末PANSS阴性量表分与DUP有相关性(r=0.483,P=0.004);(3)复发组与未复发组患者比较,APGAR总分、适应度、亲密度分均有显著差异(APGAR总分:(5.91±1.62) vs (7.13±1.47),t=-3.631,P=0.000;适应度:(1.53± 0.51) vs (1.71±0.34),t=-2.752,P=0.008;亲密度:(1.09±0.29) vs (1.25±0.43),t=-2.028,P=0.046.结论 长DUP和低家庭功能水平,对首发精神分裂症患者1年内的复发可能有不良影响.

The effect of DUP and family function on psychosis relapse within one year following first-episode schizophrenia

Objective The purpose of this study was to investigate the effect of DUP and family function on psychosis relapse of first--episode schizophrenia in one year follow up. Methods The first-episode schizophrenics were followed up for one year. The Symptom Onset for Schizophrenia（SOS） ,Brief Psychiatric Rating Scale（BPRS）, Positive and Negative Syndrome Scale （PANSS） and APGAR were used to measure DUP,psychiatric symptom and family function at baseline and the end of follow--up and the relapse time was record. Results （1）95 schizophrenics were included in our study. Among those, 87 finished one year follow--up and 34 of them had the psychotic symptoms recurrence. There was signifi- cant difference between the DUP of the relapse group and no relapse group but no correlation between DUP and the relapse time. （2）DUP of the relapse group was positively correlated with the negative symptoms factor scores of PANSS at the one year follow--up. （3）There was significant difference in the total scores,adaptation factor and intimacy {actor scores of APGAR between the relapse group and no relapse group. Conclusions The more DUP,the easier to recur and the more severe negative symptoms,but the good family support can decrease the recurrence of schizophrenia.