半封闭管理联合农场劳动对精神分裂症长期住院患者阴性症状的 影响
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上海市公共卫生体系建设三年行动计划项目(GWIV-6);2019 上海交通大学“交大之星” 计划医工交叉研究基金项目(YG2019QNB07)


Effects of semi-closed management combined with farm labor intervention on negative symptoms and social function in chronic schizophrenic patients with long-term hospitalization
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    摘要:

    目的 探讨半封闭式管理加农场劳动对长期住院的慢性精神分裂症患者阴性症状和社会 功能的影响。方法 前瞻性纳入 2017 年 9 月至 2018 年 9 月于上海市奉贤区精神卫生中心住院的 80 例 慢性精神分裂症患者,按照随机数字表分为干预组(n=40)与对照组(n=40),干预组给予抗精神病药物结 合半封闭式干预加农场劳动管理,对照组给予抗精神病药物结合封闭式管理,持续 12 个月。对所有受 试者在干预前后进行阳性与阴性症状量表(PANSS)、住院精神病人社会功能评定量表(SSFPI)和自知力 与治疗态度问卷(ITAQ)评估。结果 重复测量方差分析结果显示,PANSS 的阳性症状因子分显示分组 主效应差异有统计学意义(F=4.887,P=0.030);阴性症状因子分显示时间和分组交互效应差异有统计学 意义(F=6.249,P=0.015),干预组在 12 个月末阴性症状分有下降;一般精神病理症状两组在时间主效应、 分组主效应、时间和分组交互效应上差异均无统计学意义(均P> 0.05);SSFPI 的社会性活动技能显示, 时间主效应差异有统计学意义(F=9.648,P=0.003),但分组主效应和时间与分组交互效应差异均无统计 学意义(均P> 0.05);SSFPI 日常生活能力、动性和交往情况两组在时间主效应、分组主效应、时间和分 组交互效应上差异均无统计学意义(P> 0.05)。ITAQ 量表总分显示时间和分组交互效应差异有统计学 意义(F=36.865,P< 0.001)。结论 半封闭式管理加农场劳动可以有效地改善长期住院慢性精神分裂 症患者阴性症状、自知力与治疗的态度,对社会功能影响不明显。

    Abstract:

    Objective To explore the effect of semi-closed management on negative symptoms and social function in chronic schizophrenic patients with long-term hospitalization. Methods A total of 80 patients with chronic schizophrenia hospitalized in Shanghai Fengxian District Mental Health Center from September 2017 to September 2018 were enrolled prospectively. All the subjects were divided into the intervention group (n=40) and the control group (n=40). The intervention group was given antipsychotics combined with semi closed intervention and farm labor management, while the control group was given antipsychotics combined with closed management for 12 months. All subjects were assessed by the Positive and Negative Symptom Scale (PANSS), Scale of Social Function of Psychosis Inpatients (SSFPI), and Insight and Treatment Attitude Questionnaire (ITAQ) before and after the intervention. Results The results of repeated measurement analysis of variance showed that the positive symptom factors indicating statistical significance in group main effect (F=4.887, P=0.030), while the negative symptom factors indication statistical significance in both time and group interaction effect (F=6.249, P=0.015). The score of negative symptoms of the intervention group decreased at the end of the 12th month. There was no significant difference in time main effect, group main effect, time and group interaction between the two groups (P> 0.05). The social activity skills of SSFPI showed that there was significant difference in the main effect of time (F=9.648, P=0.003), however there was no significant difference in the main effect of group and the interaction effect between group and time (P>0.05). There was no significant difference in the main effect of time, group main effect, time and group interaction between the two groups (P>0.05). The total score of ITAQ showed significant difference in time and group interaction effect (F=36.865, P<0.001). Conclusions Semi-closed management and farm labor can effectively improve the negative symptoms, selfknowledge and treatment attitude of long-term inpatients with chronic schizophrenia, but have no significant impact on social function.

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李鲜鲜 张平 王芳 王苹 陶英华 徐兰 汪崇泽 吕钦谕 易正辉.半封闭管理联合农场劳动对精神分裂症长期住院患者阴性症状的 影响[J].神经疾病与精神卫生,2020,20(1):
DOI :10.3969/j. issn.1009-6574.2020.01.005.

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  • 在线发布日期: 2020-07-07