《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (4): 378-381.

• 论文 • 上一篇    下一篇

精神分裂症复发再入院影响因素及管理治疗研究

吴洪军，张伟娟，徐丽萍，周先华，施媛媛，丁跃庆   

  1. 九江市第五人民医院精神科，江西九江市332000。
  • 收稿日期:2013-08-05 修回日期:2013-12-23 出版日期:2014-04-25 发布日期:2014-04-25

Factors Related with Schizophrenia Relapse and Management

WU Hong-jun, ZHANG Wei-juan, XU Li-ping, et al.   

  1. Department of Psychiatry,the Fifth People's Hospital of Jiujiang, Jiujiang 332000, Jiangxi, China
  • Received:2013-08-05 Revised:2013-12-23 Published:2014-04-25 Online:2014-04-25

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被引次数

27

摘要： 目的探讨精神分裂症复发再入院的影响因素，研究重性精神疾病管理治疗对精神分裂症复发再入院的干预效果。方法以2007 年首次发病在本院住院治疗的368 例精神分裂症患者为研究对象，使用生活事件量表(LES)、社会支持评定量表(SSRS)、自编调查表等对复发因素进行Logistic 回归分析。在此基础上分为抗精神病药物开放治疗对照组(对照组，n=184)和重性精神疾病管理治疗干预组(干预组，n=184)，观察5 年来重性精神疾病管理治疗对精神分裂症复发再入院的影响。结果单因素回归分析显示，年龄、婚姻、家族史与精神分裂症复发再入院不相关(P>0.05)。性别、未治疗的精神病期(DUP)、负性生活事件是复发再入院的危险性因素(P<0.05)；受教育程度、服药依从性、社会支持是精神分裂症复发再入院的保护性因素(P<0.05)。多因素回归分析显示，服药依从性、社会支持、负性生活事件是复发再入院的主要影响因素(P<0.05)。5 年来干预组的复发再入院率较对照组下降(P<0.05)。结论服药依从性、社会支持、负性生活事件是精神分裂症复发再入院的主要影响因素，重性精神疾病管理治疗干预是降低复发再入院率的重要措施。

关键词: 精神分裂症, 复发再入院, 重性精神疾病管理治疗, 心理社会干预

Abstract: Objective To explore the factors related with relapse of patients with schizophrenia, and to assess the effect of management on this population. Methods 368 patients who were first episode and hospitalization in 2007 were recruited, and investigated with the Live Events Scale (LES), Social Support Rating Scale (SSRS). They were divided into control group (only antipsychotic treatment, n=184) and management group (severe mental illness management, n=184) and accepted the management for 5 years. Results The single factor regression showed that age, marriage and family history were not related with schizophrenia relapse (P>0.05). Gender, duration of untreated psychosis (DUP) and negative life events were risk factors of relapse (P<0.05); Education, medication adherence and social support were protective factors of relapse (P<0.05). Multivariate regression analysis showed that medication adherence, social support and negative life events were the main factors related with relapse (P<0.05). The rate of relapse was lower in the management group than in the control group (P<0.05). Conclusion Medication adherence, social support and negative life events are the main factors related with relapse. Management on the schizophrenia is one of the most important ways to reduce schizophrenia relapse.

Key words: schizophrenia, relapse, severe mental illness management, psychosocial intervention