社区精神分裂症患者综合干预前后认知功能改变分析

目的 探讨社区综合干预模式对精神分裂症患者认知功能的影响。方法 将符合纳入标准的192例精神分裂症患者随机分组，分别为综合干预组97例，对照组95例。所有患者均接受常规社区医疗卫生服务，根据病情接受相应的药物治疗。干预组患者及家属接受精神分裂症知识培训，社交技能康复训练，包括训练患者手工技能、角色扮演和情景交流等，持续一季度，干预过程中特别强调亲属对患者的交流和帮助。干预措施对各组的影响采用重复测量资料的方差分析分析主效应和交互效应；不同分组间比较采用独立样本的t检验；同一组不同时间点比较采用配对设计资料的t检验；定性资料间比较采用卡方检验。结果 干预6个月、12个月后，阳性和阴性症状量表、康复状态量表、社会功能缺陷筛选量表、世界卫生组织生存质量测定量表简表和精神分裂症认知功能成套测验得分均为综合干预组优于对照组（P＜0.05），干预前后组内比较，综合干预组社交技能和认知功能改善良好（P＜0.05），对照组没有改变。综合干预组患者复发率低于对照组（χ2 = 11.389,P = 0.001）。结论 社区综合技能干预模式能提高精神分裂症患者的社会功能，并可有效改善其认知功能。

Analysis of comprehensive intervention on the change of cognitive function among patients with schizophrenia in community

Objective To discuss the effect of comprehensive intervention on cognitive function among schizophrenic in community. Methods 192 schizophrenic patients in community who were in accordance with the inclusive criteria were randomly divided into comprehensive intervention group (97 cases) and blank control group (95 cases) respectively. All patients were given conventional community mental health services and received anti-psychotics treatment. Patients and their family in comprehensive intervention group were provided with knowledge training about schizophrenic and sociality skills rehabilitation training (handmade skills、role playing、situational communication, et al). Analysis of variance for repeated measurement data was used to compare the interaction effect and the main effect. The same group at different time was analyzed by the paired t-test, and the result in different group was analyzed by the independent-samples t-test. Qualitative data were compared by means of the χ2 test. Results At the end of six and twelve months about comprehensive intervention, the scores of the comprehensive intervention group were all better than those of the blank control group in PANSS, MRSS, WHOQOL-BREF and MCCB（P<0.05）. Intra-group comparison before and after the intervention: the social skill and the cognitive function of improvement were excellent in comprehensive intervention group(P<0.05); there had no change in blank control group（P>0.05）. The recurrence rate in comprehensive intervention group was significantly lower than that in blank control group (χ2=11.389, P=0.001). Conclusion Comprehensive skill intervention on schizophrenic in community can improve the social function of schizophrenic patients, and can significantly improve the cognitive function.