精神分裂症患者出院后2年的复发情况调查

目的:调查精神分裂症患者出院后2年的服药依从性和复发情况以及复发的相关影响因素。方法:选取出院的精神分裂症患者371例,自制调查问卷,回顾性调查出院后第1年及第2年时的复发率、服药认识、依从性、就诊及工作/学习情况;使用Logistic回归分析复发的相关影响因素。结果:患者出院后第1年及第2年复发率分别为32.9%(122例)和40.2%(72例)。出院后第1年复发组与未复发组在对服药的认识、依从性、复诊频率及坚持正常工作/学习比较差异无统计学意义(P0.05);第2年复发组对服药的认识(χ2=17.554)、依从性(χ2=62.514)、复诊频率(χ2=4.131)及坚持正常工作/学习(χ2=9.806)方面均明显差于未复发组(P0.05或P0.001)。Logistic回归分析显示,第1年及第2年对服药认识积极、服药依从性好及能坚持正常工作/学习的患者复发风险更低(OR=0.152~0.376,P0.05或P0.01);而第1年的依从性、服药认识与第2年复发无相关。结论:精神分裂症患者出院后对服药认识积极、依从性好、定期复诊及能坚持正常工作/学习可有效降低复发的风险。

A investigation of relaPse in Patients with schizoPhrenia after 2 years of discharging

Objective:To explore the factors related to the relapse through studying the medication com-pliance and relapse in the schizophrenia patients after 2 years of discharge. Method:Three hundred and sev-enty-one schizophrenic patients discharged were included in the study,and then the investigation into the state of illness,compliance,the opinions on taking medicines,and relapse rate after discharge for a period of 1 year and 2 years was accomplished through self-prepared questionnaires. The influencing factors of relapse was analysed by Logistic regression analysis. Results:The relapse rate in the schizophrenic patients after 1 year from dis-charging was 32. 9%(122 examples)and the 2 year was 40. 2%(72 examples). No significant difference was found in the opinions on taking medicines,adherence,frequency of return visit and work/ study ability in the first year between the two groups. Compare to those not relapse group,the relapse group was found worse significantly in the opinions on taking medicines(χ2 = 17. 554),adherence(χ2 = 62. 514),frequency of return visit(χ2 =4. 131)and work/ study(χ2 = 9. 806),the difference was significant(P < 0. 05 or P < 0. 001). Logistic regres-sion analysis indicated that patients with positive opinions on taking medicines,good adherence and work/ study ability in the first and second year are found with lower risk of relapse(OR = 0. 152 ~ 0. 376,P < 0. 05 or P <0. 01),but the attitude and adherence to medication in the first year had no relation to the relapse in the second year. Conclusion:Active attitude to medication,good medication adherence and sticking to work/ study can effectively reduce the risk of relapse for patients with schizophrenia after discharge.