恢复期精神分裂症患者病耻感与服药依从性的相关性

目的:了解恢复期精神分裂症患者的病耻感状况,探索精神分裂症患者病耻感与服药依从性之间的关系。方法:便利选取合肥市第四人民医院住院治疗的恢复期即将出院的精神分裂症患者79例,采用Link等的病耻感量表在患者出院前测量其病耻感,并分别在出院后1个月和3个月通过电话随访评估服药依从性。结果:1在贬低-歧视感知维度得分与量表中点2.50比较无显著差异;在应付方式5个维度中有4个维度保密、退缩、教育、挑战等得分显著高于量表中点2.50;在情感体验维度,被误解得分显著高于量表中点2.50,但是不同/羞耻得分却显著低于量表中点2.50;2患者的住院次数、年龄、病程对病耻感有一定的影响;3患者出院后1个月、3个月的服药依从性与"保密"、"被误解"呈显著相关(P<0.001)。结论:精神分裂症患者普遍存在病耻感,患者出院后的服药依从性与"保密"应付方式及"被误解"体验有较高相关性。

Internalized stigma experience of convalescent schizophrenics and medication adherence

Objective：To investigate the relationship between stigma experience condition of convalescent patients with schizophrenia and medication ad-herence.Methods： Seventy-nine schizophrenics in their convalescent status before discharge were included from the Anhui Provincial Mental Health Cen-ter using convenience sampling , and Link＇s Stigma-Withdrawal Scale was used to measure the stigma status prior to hospital discharge .The medication ad-herence condition was investigated one month and three months after discharge through telephone follow .Results：①No difference was observed between the scoring on the perceived devaluation-discrimination scale and the 2.50 midpoint reference, yet the scores were significantly higher by the secrecy, withdrawal, education and challenges on the components of copying style as well as misunderstanding on the emotional scale compared to the reference （2. 50）.Whereas the patients with diverse stigma experience scored significantly lower than the midpoint（2.50）;②The influential factors with the stigma of the patients were associated with hospitalization frequencies , ages and course of disease;③Medication adherence was positively correlated with ＂confiden-tial＂and ＂misunderstood＂one month and three months after discharge（P〈0.001）.Conclusion： Internalized stigma appears prevalent in the convales-cent patients with schizophrenia, and the medication adherence after discharge is highly involved in ways to maintain secrecy and sense of misunderstood by others.