《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (02): 183-184.

• 社区康复 • 上一篇    下一篇

精神分裂症社区监管治疗分析

赵明1;朱韶敏1;张玲1;赵鹏2   

  1. 1. 吉林省精神病防治办公室，吉林四平市 136000;2. 吉林省精神病医院，吉林四平市 136000
  • 收稿日期:2008-08-26 修回日期:2008-10-17 出版日期:2009-02-01 发布日期:2009-02-01

Supervision of Schizophrenia in Community

ZHAO Ming, ZHU Shao-min, ZHANG Ling, et al   

  1. Mental Disease Control and Prevention Office of Jilin Province, Siping 136000, Jilin, China
  • Received:2008-08-26 Revised:2008-10-17 Published:2009-02-01 Online:2009-02-01

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摘要： 目的 探讨由政府出资，卫生部门组织，社区个案管理员、民警、社区医疗站、精神科医护人员及家属组成“精防队伍”共同参与对患者进行社区防治的应用价值。方法 对150例有肇事肇祸倾向的发病期的精神分裂症患者在社区中建立个案管理制度，进行一年的监管治疗，采用每月一次的暴力分级和暴力次数统计，使用社会功能缺陷筛选量表（SDSS）进行评分。结果 150例患者经过一年的监管治疗，暴力分级和次数与监管治疗前比较，危险性评估暴力5级由20人次降至0人次，暴力4级由68人次降至2人次；暴力3级由66人次降至4人次，暴力2级由258人次降至12人次，暴力1级由432人次降至24人次，暴力消失者由0人次增至72人次；SDSS量表测查严重社会功能缺陷由监管治疗前的101例降至12例，轻度功能缺陷由19例增至36例，社会功能无缺陷由0例增至72例。结论 在社区中建立个案管理制度，通过精神疾病防治队伍对精神分裂症患者进行监管治疗、追踪随访和康复指导，是降低肇事肇祸率、减少患者社会功能缺陷、促进患者社会康复的有价值方法。

关键词: 个案管理制度, 精神分裂症, 社区监管治疗, 危险性评估

Abstract: Objective To explore the significance of Community Mental Health Service funded by the government, organised by the Health Department and participated by the Community Psychiatric Service, which consists of community case managers, policemen, community health station, doctors, nurses and family of patients.Methods 150 patients, having the tendency to cause trouble or disturbance in their psychotic episodes, were placed in a case management system, monitored and treated throughout the year, gathered statistics for their number and extent of violence every month, and scored according to Social Disability Screening Schedule (SDSS).Results After one year's monitoring and treatment, the total number of occurrence of violence 5 grade among the 150 patients decreased from 20 person-times to 0 person-times; violence 4 grade decreased from 68 person-times to 2 person-times; violence 3 grade decreased from 66 person-times to 4 person-times; violence 2 grade decreased from 258 person-times to 12 person-times; violence 1 grade decreased from 432 person-times to 24 person-times. The number of patients who lost their violent tendency increased from 0 person-times to 72 person-times.Conclusion To establish community case management systems, monitor, treatment, conduct follow-up studies and providing appropriate recovery guidance for schizophreniac patients through the Community Psychiatric Service, are the effective ways to decrease the rate of causing trouble or disturbance, reduce the patients' social disability, and facilitate the patients' recovery of social functions.

Key words: case management system, schizophrenia, community monitoring and treatment, risk assessment