社区精神分裂症患者社会功能缺陷形成的多因素分析

目的探讨社区精神分裂症患者社会功能缺陷的因素。方法用社会功能缺陷评定量表(SDSS)和护士用简明精神病量表(N-BPRS)对108例出院回归社区的精神分裂症患者进行为期1 a的随访观察和评定。结果与出院时相比,1 a后患者的SDSS和N-BPRS得分均显著性增加(P<0.01)。患者的社会功能水平与患者的职业和工作、婚姻职能、父母职能、社会性退缩、家庭外的社会活动、家庭内的活动过少、家庭职能、个人生活自理、对外界的兴趣和关心、责任心和计划性存在高度正相关(r=0.549～0.736,P<0.01)。多因素回归分析表明,出院1 a后精神分裂症患者的社会功能,主要与出院时病情、1 a后病情、婚姻状况、职业、家庭经济及发病次数有关(R2=0.729,F=37.682,P<0.01)。结论出院时病情与1 a后的病情、恶劣的婚姻状况、家庭经济困难及反复发作与社会功能缺陷有明显相关。出院后回归社区的精神分裂症患者,应接受持续的家庭干预和康复训练,才能维持既有的疗效和社会功能水平。

Multiplicity of social disabilitry of the patients with schizophrenia in community

Objective To investigate the factors of social disabilitry of the patients with schizophrenia in community.Methods One hundred and eight patients who had left hospital to community were followed up for one year by social disability screening schedule(SDSS) and nurse′s BPRS(N-BPRS).Results The total score of SDSS and N-BPRS were higher one year after leaving hospital(P<0.01).The social functional level of patients with schizophrenia was positively related to occupation and Job,marital status,parent′s functioning,social withdraw,less activities in and out home,familial functioning,self care,interest and concern about others,responsibility and plan(r=0.549～0.736,P<0.01).Muitiple factors regression analysis showed that the patients,social function one year after discharge was mainly related to pathogenetic condition,marriage,job,financial status and relapse times(R2=0.729,F=37.682,P<0.01).Conclusion Pathogenetic condition,unsatisfied marriage,financial difficulty of family and repeating relapse are obviously related to social disabilitry in patients with schizophrenia.The durative intervention and rehabilitation training should be given to the outpatients in community in order to maintain the therapeutic effect and social function.