儿童少年精神分裂症复发因素分析

目的探讨儿童少年精神分裂症复发的因素并提出应对策略。方法随访在新乡医学院第二附属医院治疗的166例儿童少年精神分裂症患者2 a,将2 a内患儿复发2次以上的60例为复发组,病情稳定2 a以上未复发患者60例为对照组,病情无明显缓解患者(27例)和脱落患者(19例)不计入统计分析。评定复发组和对照组病情严重程度、家庭经济状况、父母受教育年限、患者自知力、起病年龄、药物不良反应、服药依从性等因素对复发的影响。结果2组患儿在不同经济收入家庭中的分布比较差异有统计学意义(χ2=6.351,P=0.042),在不同受教育年限的家庭和有无自知力方面中的分布差异无统计学意义(χ2=3.472、3.142;P=0.176、0.076);起病年龄和阳性与阴性症状量表评分2组比较差异无统计学意义(t=1.313、-0.955;P=0.192、0.341);2组锥体外系反应量表(RSESE)评分、UKU不良反应量表评分、服药依从性评分比较差异有统计学意义(t=-2.094、2.058、-2.932;P=0.038、0.042、0.004)。服药依从性与RSESE评分、UKU不良反应量表评分呈负相关(r=-0.546、-0.569,P=0.000、0.000);RSESE评分、UKU不良反应量表评分一致性很高(r=0.968,P=0.000)。结论经济状况和药物不良反应而导致服药依从性差是导致儿童少年精神分裂症复发的主要因素;减少药物不良反应、坚持药物治疗是防止精神分裂症复发的有效途径。

Analysis of relapse factors in children and adolescents with schizophrenia

Objective To explore the relapse factors and propose coping strategies for children and adolescents with schizophrenia.Methods One hundred and sixty-six children and adolescents with schizophrenia of the Second Affiliated Hospital of Xinxiang Medical College were followed up for two years,sixty patients with recurrence more than two times were regarded as recurrence group,sixty patients without recurrence were regarded as control group,twenty patients without obvious remittance and nineteen loss of follow-up patients were not included in the statistical analysis.The influences of the severity of the disease,familial economic status,the period of education of parents,insight of patients,age of onset,adverse drug reactions and treatment compliance on recurrence were evaluated in two groups.Results There was statistical difference in the familial economic status between two groups(χ2=6.351,P=0.042),but there was no statistical difference in the period of education of parents and insight of patients between two groups(χ2=3.472,3.142;P=0.176,0.076).There was no statistical difference in the age of onset and positive and negative symptoms scales scores between two groups(t=1.313,-0.955;P=0.192,0.341).There was statistical difference in the rating scale for extrapyramidal side effects(RSESE) scores,Kliniske Undersgelser(UKU) side effect rating scales scores,and treatment compliance scores between two groups(t=-2.094,2.058,-2.932;P=0.038,0.042,0.004).Drug compliance was negatively correlated with RSESE scores and UKU side effect rating scales scores(r=-0.546,-0.569;P=0.000,0.000).The concordance of RSESE scores and UKU adverse scale scores was very high(r=0.968,P=0.000).Conclusion Economic situation and poor compliance caused by adverse drug reactions are the main factor of recurrence in children and adolescent with schizophrenia.Decreasing adverse drug reaction and keeping drug treatment is effective way to prevent the recurrence of schizophrenia.