佛山顺德区有肇事肇祸倾向重性精神疾病患者社区个案管理效果的干预12个月随访

目的:探讨社区个案管理对佛山市顺德区有肇事肇祸倾向的重性精神疾病患者社会功能、生活质量和家庭负担的影响。方法:将有肇事肇祸倾向的重性精神疾病患者分成干预组和对照组,对干预组实施个案管理模式,而对照组仅维持原来的社区随访服务。用简明精神病量表(BPRS)、社会功能缺陷筛查量表(SDSS)、Morning Side康复状态量表(MRSS)、生活质量量表和家庭负担会谈量表(FIS)评定两组患者的精神症状、社会功能、生活质量和家庭负担,并计算两组患者的肇事肇祸率。结果:在干预12个月后,干预组BPRS评分(32.51±4.03)和(34.18±4.46)]、SDSS评分(7.51±2.90)和(7.99±4.16)]、MRSS评分(56.09±20.61)和(58.74±22.30)]和FIS量表评分(35.20±10.31)和(37.28±14.24)]显著低于对照组(P0.05或P0.01),而干预组生活质量量表评分(13.32±4.75)显著高于对照组(12.58±4.97)(P0.05)];干预组的肇事肇祸率(12.6%)显著低于对照组(18.2%,P0.05)。结论:对有肇事肇祸倾向的重性精神疾病患者实施个案管理,能有效改善患者的精神症状,降低肇事肇祸率,改善社会功能和生活质量,减轻患者的家庭负担。

One-year follow up of community case management effect on severe psychosis patients with trouble-making inclination in Shunde district of Foshan city

Objective：To explore the efficacy of community case management on social function,life quality and family burden in severe psychosis patients with trouble-making inclination in Shunde district of Fos-han city. Method：The severe psychosis patients with trouble-making inclination were assigned into interven-tion group and control group. The intervention group received case managements for 1 year,while the control group maintained the original community serve. The psychiatric symptom,social function,life quality and family burden of all patients were evaluated with brief psychiatric rating scale（ BPRS）,social disability screening schedule（SDSS）,morning side rehabilitation status scale（MRSS）quality of life scale and burden on the family of interview schedule（FIS）. Results：At the end of one year,the scores of BPRS（32. 51 ±4. 03）vs（34. 18 ± 4. 46）],SDSS（7. 51 ± 2. 90）vs（7. 99 ± 4. 16）],MRSS（56. 09 ± 20. 61）vs（58. 74 ± 22. 30）]and FIS （35. 20 ± 10. 31）vs（37. 28 ± 14. 24）]in intervention group were obviously less than those in control group （P 〈 0. 05 or P 〈 0. 01）,while the score of quality of life scale（13. 32 ± 4. 75）was obviously higher than that in control group（12. 58 ± 4. 97）,（P 〈 0. 05）]. The rate of causing trouble in intervention group（12. 6% ） was obviously lower than that of control group（18. 2% ,P 〈 0. 05）. Conclusion：Case management contrib-utes to the reduction of psychiatric symptoms,causing trouble rate and family burden,and to the improvement of social function and life quality for severe psychosis patients with trouble-making inclination.