首发精神分裂症患者的生活质量评估

目的评估首发分裂症患者的生活质量，及生活质量与精神症状的相关性。方法评估447例患者基线、随访6个月、随访1年时阳性和阴性症状量表（PANSS）、健康状况调查问卷（SF-36）、社会功能缺陷筛选量表（SDSS）、生活满意度量表（LSR）。主要根据SF-36评估首发分裂症患者的生活质量，并将SF-36与PANSS、SDSS、LSR作相关分析。结果首发精神分裂症患者在躯体角色功能（RP）、社会功能（SF）、情绪角色功能（RE）3个维度平均分显著低于杭州市居民的数据。除精力（VT）外，其余7个维度与PANSS的阳性症状分、阴性症状分、一般精神病理分以及SDSS均呈负相关，与LSR呈正相关。而VT与PANSS的阴性症状分及LSR呈负相关。随访1年问躯体健康（PF）、躯体角色功能（RP）、躯体疼痛（BP）、总体健康（GH）、社会功能（SF）、情绪角色功能（RE）、心理健康（MH）等7个维度得分显著提高。结论首发分裂症患者的情绪角色功能、躯体角色功能和社会功能受损明显，经1年治疗后上述功能均能明显改善。除精力感外，精神症状缓解越明显，生活质量越高，提示了早期治疗的重要性。同时也表明SF-36可适用于评估分裂症患者的生活质量。

Assessment of health-related quality of life in patients with first-episode schizophrenia

Objective:To assess the health-related quality of life in patients with first-episode schizophrenia.Methods:Four hundreds and forty-seven patients with first-episode of schizophrenia were included.The Short-Form-36 of Health Survey(SF-36),the Positive and Negative Syndrome Scale(PANSS),the Life Satisfaction Rating Scales(LSR)and the Social Disability Screening Schedule(SDSS)were used to evaluate the quality of life and the related factors.Results:Baseline scores of SF-36 were significantly lower in 3 subscales as role-emotional,role-physical and social function compared than the normative scores.Most subscales exhibited significant improvement between baseline and one year except vitality.All subscales of SF-36 except vitality were negatively correlated with the positive,negative and general psychopathology subscores of PANSS and the score of SDSS,and positively correlated with the score of LSR.The vitality subscale was negatively correlated with the negative subscore of PANSS and the LSR.Conclusion:Patients with first-episode schizophrenia showed a selectively low quality of life in role-emotional,role-physical and social function,which were significant improved after one-year treatment.The quality of life is associated with less psychiatric symptoms,so it's important to start treatment as early as possible,and SF-36 may be suitable for the assessment of quality of life in patients with schizophrenia.