自我管理项目对双相障碍患者服药依从性与社会功能的影响

目的探讨自我管理项目对双相障碍患者服药依从性与社会功能的影响。方法以在精神科住院的符合《精神障碍诊断与统计手册（第5版）》（DSM-5）双相障碍诊断标准的患者为研究对象，所有患者均处于急性发作期。采用随机数字表法将患者分为干预组与对照组，其中干预组45例，对照组42例。干预组在药物治疗与常规护理基础上进行双相障碍自我管理项目干预，对照组给予药物治疗与常规护理，两组分别在入组前、第3个月末、第6个月末进行杨氏躁狂评定量表（YMRS）、17项版汉密尔顿抑郁量表（HAMD-17）、服药态度问卷（DAI-30）、社会功能缺陷筛选量表（SDSS）的评估。结果两组患者在入组前YMRS、HAMD-17、DAI-30、SDSS总分比较差异均无统计学意义（P＞0.05）。YMRS第6个月末干预组评分低于对照组，差异有统计学意义（P=0.028）。DAI-30总分在第3个月末、第6个月末均高于对照组，差异均有统计学意义(P＜0.01)。SDSS总分在第3个月末、第6个月末均低于对照组，差异均有统计学意义(P＜0.01)。结论在药物治疗与常规护理的基础上，双相障碍自我管理项目能够提高患者的服药依从性，改善患者的社会功能。

Effect of self-management program on medication compliance and social function in patients with bipolar disorder.

ObjectiveTo evaluate the effects of self-management program on medication compliance and social function in patients with bipolar disorder. Methods The bipolar disorder patients who admitting to the psychiatry department of the People′s Hospital of Guangdong were chosen to participate in this study. All the patients met the diagnostic criteria for bipolar disorder according to the diagnostic criteria and statistical manual of mental disorders (5th Edition) (DSM-5) and were in acute phase from September, 2016 to September, 2018. They were divided into intervention group and control group by random number table, 45 cases in the intervention group and 42 cases in the control group. The intervention group was treated with bipolar disorder self-management project on the basis of drug treatment and routine care, and the control group was given with drug treatment and routine care. Yung Mania Rating Scale (YMRS), Hamilton Depression Scale 17 items (HAMD-17), Drug Attitude Questionnaire (DAI-30) and Social Function Deficit Screening Scale (SDSS) were performed before grouping, at the end of the third month and the sixth month. ResultsThere was no significant differences in YMRS, HAMD-17, DAI-30 or SDSS between the two groups before grouping (all P>0.05). The score of YMRS in the intervention group was significantly lower than that of the control group at the end of the sixth month (P=0.028). The scores of DAI-30 were significantly higher than that of the control group at the end of the third month and the sixth month (both P<0.01). The SDSS scores were significantly lower than the control group at the end of the third month and the sixth month (both P<0.01). ConclusionOn the basis of drug therapy, the bipolar disorder self-management program can improve the patients′ medication compliance and social function.