慢性精神分裂症院内职业康复18年随访观察

目的随访职业康复对长期住院的慢性精神分裂症患者康复效果及病情转归规律，寻找能有效改善无家可归的民政精神病患者的院内康复途径。方法对62例精神分裂症康复期患者安排缝纫、纺织机电、织袜、做花圈、绿化、洗衣、理发等职业工作，并进行18年的追踪观察；同时与50例未参加职业康复的慢性精神分裂症患者进行对照。由两名主治医师对所有患者分别于人组前及第5年、10年、18年用SDSS、IPROS和BPRS各评定一次。结果基线时职业组IPROS分值比对照组分值低5．89，随访18年时职业组比对照组高55．34。基线时职业组SDSS2．80±0．59，对照组3．02±1．15（t=1．26，P〉0．05），终点时分别为3．38±0．65，2．39±1．15（t=5．01，P〈0．001）。疾病的复发次数及用药量均明显低于对照组。结论职业康复对慢性精神分裂症患者恢复社会功能，改善残疾程度，稳定病情等方面起到积极的不可替代的作用。

Eighteen years observation of occupational rehabilitation for chronic schizophrenic

Objective： To track the effect and the progression of hospital occupational rehabilitation in chronic inpatients with schizophrenia. And to seek the effective hospital rehabilitate ways for those homeless civil schizophrenia patients. Methods： Sixty - two convalescence schizophrenia patients were arranged to attend the occupation of sewing, textile, knitting socks, wreathing, green, laundry, barber and so on, and had been observed for eighteen years with 50 other chronic schizophrenic inpatients as control. At the time of baseline, 5 years, 10 yars and 18years, they were evaluated with Social Disability Screening Schedule （SDSS）,Inpatient Psychiatric Rehabilitation Outcome Scsle （IPROS）and the Brief Psychiatric Rating Scale （BPRS）. Results：At the baseline, the scores of IPROS in occupational group was 5.89 lower than control group while after 18 years was 55.34 higher. The score of SDSS in occupational group was 2.80 ±0.59 and the control group 3.02 ±1.15 （ t = 1.26, P 〉 0.05 ）. At the final point, the score of occupational group and control group was respectively 3. 38 ±0.65 and 2.39 ±1.15 （ t = 5.01, P 〈 0.001 ）. The frequency of recurrence of the disease and average dose of medication in occupational group were also significantly lower than the compare group. Conlusion： Occupational rehabilitation has positive and irreplaceable effect for chronic schizophrenia patients on restoring social function, improving the degree of disability and stabilizing illness.