CAJ | 학술논문

目的：探讨系统行为干预对流浪精神分裂症患者疗效的影响。方法将62例流浪精神分裂症患者按随机数字表法分为研究组（32例）和对照组（30例）。对照组给予维持药物治疗（原则上首选口服非典型抗精神病药物，如氯氮平、利培酮等来维持治疗，但视病情需要可适当选用典型抗精神病药处理）及常规院内管理（常规临床护理，定时吃药，规律饮食及作息），3个月为1个疗程；研究组在流浪精神分裂症患者入院服药治疗2周后（治疗同对照组），辅以系统行为干预措施：示教为45 min·次－1，2次·周－1，实践活动根据患者院内生活内容每天开展时间不少于2 h，3个月为1个疗程。采用简明精神病评定量表（BPRS）、社会功能评定量表（SSSI）及日常生活能力评定量表（ADL）分别在系统行为干预前、干预3个月后对2组患者进行评估。结果2组患者在治疗前 BPRS、ADL、SS-SI评分比较差异均无统计学意义（均P＞0．05）；2组在治疗3个月后BPRS、ADL、SSSI评分较治疗前均显著降低，研究组较对照组降低的更明显（P＜0．05或P＜0．01）。结论系统行为干预不仅可以加强药物对流浪精神分裂症患者的治疗效果，同时可改善其阴性症状，提高其日常生活能力及整体社会功能。
목적：탐토계통행위간예대류랑정신분렬증환자료효적영향。방법장62례류랑정신분렬증환자안수궤수자표법분위연구조（32례）화대조조（30례）。대조조급여유지약물치료（원칙상수선구복비전형항정신병약물，여록담평、리배동등래유지치료，단시병정수요가괄당선용전형항정신병약처리）급상규원내관리（상규림상호리，정시흘약，규률음식급작식），3개월위1개료정；연구조재류랑정신분렬증환자입원복약치료2주후（치료동대조조），보이계통행위간예조시：시교위45 min·차－1，2차·주－1，실천활동근거환자원내생활내용매천개전시간불소우2 h，3개월위1개료정。채용간명정신병평정량표（BPRS）、사회공능평정량표（SSSI）급일상생활능력평정량표（ADL）분별재계통행위간예전、간예3개월후대2조환자진행평고。결과2조환자재치료전 BPRS、ADL、SS-SI평분비교차이균무통계학의의（균P＞0．05）；2조재치료3개월후BPRS、ADL、SSSI평분교치료전균현저강저，연구조교대조조강저적경명현（P＜0．05혹P＜0．01）。결론계통행위간예불부가이가강약물대류랑정신분렬증환자적치료효과，동시가개선기음성증상，제고기일상생활능력급정체사회공능。
ABSTRACT:Objective To investigate the influence of systematic behavior intervention on home-less patients with schizophrenia.Methods Sixty-two homeless patients with schizophrenia were randomly divided into two groups.In the control group(n=30),patients received oral atypical an-tipsychotic drugs(such as clozapine and risperidone)and general hospital management (routine clinical care,prescribed medication,and regular diet and rest).Furthermore,typical antipsychotic drugs were properly used according to the medical necessity.In the study group(n=32),patients were additionally given systematic behavior intervention after drug therapy for 2 weeks.The teaching was performed twice per week(45 minutes per time),and practical activities were carried out for at least 2 hours per day according to the daily life.The duration of a treatment course was three months.Patients were tested with the Brief Psychiatric Rating Scale(BPRS),Social Skills of chronic schizophrenia Inpatients Scale(SSSI)and Activities of Daily Scale(ADL)before and after behavior intervention for 3 months.Results There were no significant differences in BPRS,ADL and SSSI scores between the two groups before treatment (P>0.05 ).After treatment for 3 months,BPRS,ADL and SSSI scores significantly decreased,and the decrease in study group was more obvious than that in control group(P<0.05 or P<0.01).Conclusion Systematic behavior intervention can strengthen the effectiveness of medicine,ameliorate the negative symptoms,in-crease the ability to perform activities of daily living and improve the overall social functions in homeless patients with schizophrenia.