CAJ | 학술논문

目的探讨家庭干预对首发精神分裂症患者预后的影响.方法将76例首发精神分裂症患者采用随机数字表法分为干预组和对照组各38例,两组均采用药物治疗,干预组合并家庭干预进行为期1年的随访研究.在干预前后采用简明精神病量表(BPRS)及家庭亲密度和适应性量表(FACESⅡ-CV)分别于基线时及随访结束时进行评估.结果 1年随访结束时,干预组和对照组BPRS评分总分[(19.5±7.7),(21.8±7.2)分]较基线时[(34.5±13.2),(34.9±14.3)分]均有明显下降,但干预组在焦虑抑郁以及缺乏活力因子[(2.1±0.9),(4.4±0.6)分]改善优于对照组[(3.6±0.8),(7.6±0.5)分],差异均有统计学意义(t分别为5.67,5.37,-8.9,-19.8;P＜0.01)；干预组FACESⅡ-CV的实际亲密度、理想亲密度、实际适应性以及理想适应性等因子各因子分评分较基线时均有明显升高,差异有统计学意义(t分别为-2.3,-2.8,-4.9,-4.3;P ＜0.05),组间比较显示随访结束时,干预组在各因子分评分明显高于对照组,差异有统计学意义(t分别为2.2,2.6,4.0,3.8;P ＜0.05).随访时患者BPRS总分与基线期BPRS总分呈正相关(t=2.0,P＜0.05),与基线期实际亲密度(t=-4.1,P ＜0.01)、随访期实际亲密度(t=-3.6,P＜0.01)、随访期实际适应性呈负相关(t=-6.6,P＜0.01).结论精神分裂症患者在接受药物维持治疗的同时给予家庭干预,能有效改善其阴性症状,提高患者家庭亲密度和适应性,对于患者临床预后具有重要意义.
목적 탐토가정간예대수발정신분렬증환자예후적영향.방법 장76례수발정신분렬증환자채용수궤수자표법분위간예조화대조조각38례,량조균채용약물치료,간예조합병가정간예진행위기1년적수방연구.재간예전후채용간명정신병량표(BPRS)급가정친밀도화괄응성량표(FACESⅡ-CV)분별우기선시급수방결속시진행평고.결과 1년수방결속시,간예조화대조조BPRS평분총분[(19.5±7.7),(21.8±7.2)분]교기선시[(34.5±13.2),(34.9±14.3)분]균유명현하강,단간예조재초필억욱이급결핍활력인자[(2.1±0.9),(4.4±0.6)분]개선우우대조조[(3.6±0.8),(7.6±0.5)분],차이균유통계학의의(t분별위5.67,5.37,-8.9,-19.8;P＜0.01)；간예조FACESⅡ-CV적실제친밀도、이상친밀도、실제괄응성이급이상괄응성등인자각인자분평분교기선시균유명현승고,차이유통계학의의(t분별위-2.3,-2.8,-4.9,-4.3;P ＜0.05),조간비교현시수방결속시,간예조재각인자분평분명현고우대조조,차이유통계학의의(t분별위2.2,2.6,4.0,3.8;P ＜0.05).수방시환자BPRS총분여기선기BPRS총분정정상관(t=2.0,P＜0.05),여기선기실제친밀도(t=-4.1,P ＜0.01)、수방기실제친밀도(t=-3.6,P＜0.01)、수방기실제괄응성정부상관(t=-6.6,P＜0.01).결론 정신분렬증환자재접수약물유지치료적동시급여가정간예,능유효개선기음성증상,제고환자가정친밀도화괄응성,대우환자림상예후구유중요의의.
Objective To discuss the effect of family intervention on the prognosis of first-episode patients with schizophrenia.Methods Seventy-six first-episode schizophrenic patients were randomly assigned into two groups:the intervention group (n =38) and the control group (n =38).Both groups received drug treatment,while the intervention group had family intervention for a year as follow-up research.The Brief Psychiatric Rating Scale (BPRS) and Family Adaptability and Cohesion Scale (FACES Ⅱ-CV) were used to assess these patients at baseline before and after the intervention.Results At the end of follow-up,the total score of BPRS was (19.5 ± 7.7) and (21.8 ± 7.2) respectively in the intervention group and the control group,lower than its baseline as (34.5 ± 13.2) and (34.9 ± 14.3),but the score of anxiety and depression as well as lack of energy was better in the intervention group [(2.1 ±0.9) and (4.4 ±0.6)] than in the control group [(3.6 ± 0.8) and (7.6 ± 0.5)],and the differences were statistically significant (t =5.67,5.37,-8.9,-19.8,respectively; P ＜ 0.01).The score of actual cohesion,ideal cohesion,actual adaptability and ideal adaptability in FACES Ⅱ-CV improved compared to the baseline in the intervention group,and the differences were statistically significant (t =-2.3,-2.8,-4.9,-4.3,respectively; P ＜ 0.05).After the follow-up study,score of every factor was higher in the intervention group than in the control group,with statistically significant differences (t =2.2,2.6,4.0,3.8,respectively; P ＜ 0.05).During the follow-up,the total score of BPRS was positively related to BPRS at the baseline (t =2.0,P ＜ 0.05),and negatively related to actual cohesion at the baseline (t =-4.1,P ＜ 0.01),actual cohesion during follow-up (t =-3.6,P ＜ 0.01)and actual adaptability during follow-up (t =-6.6,P ＜ 0.01).Conclusions Family intervention combined with drug treatment can improve schizophrenic patients' negative symptoms,family cohesion and adaptability,which plays an important role for their prognosis.