【摘要】 目的 了解全开放管理的急性期精神分裂症患者的抑郁状况，为急性期开放管理提供参考信息。 方法 2009年10-11月，采用卡尔加里精神分裂症抑郁量表（CDSS）对95例精神分裂症患者进行调查。 结果 精神分裂症患者抑郁的发生率为38.95%。且与性别、文化程度、住院次数无关。但与病程密切相关，病程5年以上的患者抑郁状况突出。 结论 精神分裂症患者的抑郁状况明显，需要加强对病情的评估；加强对家属的教育，提高患者的社会支持；早期对患者进行心理干预；以预防自杀的发生。【Abstract】 Objective To find out the depressive situation of patients with schizophrenia in the acute phase under a whole open management, and to provide a scientific basis for the open management. Methods From October to November 2009, 95 patients with schizophrenia were investigated via Calgary depression scale with schizophrenia (CDSS). Results The incidence of depression in patients with schizophrenia was 38.95%, which had no relationship with gender, education level, or frequency of hospitalization. However, the course of the disease was closely related. The depressive symptoms were prominent in patients with the duration more than five years. Conclusion The patients with schizophrenia have obvious depressive symptoms we should. strengthen the evaluation of the disease, improve the family education and the patient′s social support, and implement psychological intervening with patients in the early phase in order to prevent the occurrence of suicide and improve the quality of management.
ObjectiveTo compare the application of self-made tumble risk factors assessment scale before and after its revision in patients with mental disorder, in order to guide the clinical work. MethodsWe retrospectively analyzed the clinical data of 2 209 patients with mental disorders who were discharged from the hospital between January 1, 2012 and December 31, 2013. All the patients in our hospital underwent the assessment by "table of tumble risk factors for hospitalized patients and nursing measures" within one hour of admission. A total score of 4 or higher meant high tumble risk, and the standardized intervention measures were taken immediately. In 2013, the assessment scale was revised, and binocular vision disorder, low compliance or communication disorders, restlessness were added as risk factors for tumble. The difference among patients with a tumble score of 4 or higher between the year of 2012 and 2013 was compared and analyzed. ResultsIn 2012, 52 patients had a tumble score of 4 or higher, among whom there were 16 males and 36 females; 35 were younger than 65 years old and 17 were older than 65 years. There were 25 patients with organic mental disorders, 10 with spirit obstacle caused by active substance, 12 with schizophrenia, and 5 other cases. In 2013, 154 patients' tumble score was 4 or higher, among whom there were 58 males and 96 females; 142 were younger than 65 years old and 12 were older than 65. Organic mental disorders occurred in 22 patients, 8 had spirit obstacle caused by active substance, 120 had schizophrenia, and there were 4 other cases. In 2013, the number of patients with a tumble score of 4 or higher were significantly more than that in 2012 and young patients with schizophrenia were also significantly more than in 2012 (P<0.05). There were two cases of tumble adverse events, while no adverse events occurred in tumble in 2013. ConclusionCognitive impairment, low compliance, communication barriers and restlessness are high risk factors for tumble in patients with mental disorders. Correct evaluation and early intervention can effectively prevent the occurrence of tumble.
ObjectiveTo explore the influence factors of therapeutic compliance and emotional expression of first-degree relatives in acute schizophrenic patients with psychotic symptoms. MethodsThe Brief Psychiatric Rating Scale (BPRS) was used to measure the severity of psychotic symptoms in sixty schizophrenic patients from June to September 2014 in West China Hospital and the Toronto Alexithymia Scale (TAS) was used to survey the emotional expression in their family members. The homemade treatment adherence scale was used to survey the treatment adherence in patients for one week. ResultsThere was a poor therapeutic compliance in nineteen patients with acute schizophrenia (32%) and the other 41(68%) had good therapeutic compliance; the relatives of schizophrenic patients had high TAS scores (male: 67.61±10.03; female: 69.68±11.46) than the normal models did (P ＜ 0.05) . The differences between the patients with different therapeutic compliance in BPRS total score, reactivator, hostile and suspicion factor (P ＜ 0.05) . The therapeutic compliance was related to the severity of the psychotic symptoms (P ＜ 0.05) . Conclusions There is a bad emotional expression in the relatives of acute schizophrenic patients. The psychotic symptoms can influence the therapeutic compliance. The milder the psychotic symptoms, the better the therapeutic dependence.
Objective To explor the influence of the hospital-community-family mental rehabilitation mode on the quality of life of patients with schizophrenia. Methods We selected 101 patients diagnosed as schizophrenia according to ICD-10, who were hospitalized in mental health center of the West China Hospital and took part in rehabilitation voluntarily after discharge. Those patients were randomly assigned to two groups. Hospital-community-family mental rehabilitation mode intervention was applied to the patients based on inpatient rehabilitation in the trial group (n=52), while inpatient rehabilitation alone was applied in the control group (n=49). The total score of quality of life, psycho-social dimension, motivation and energy dimension, score of mental disability and social function, and family social care index were recorded. Then, statistical analysis was performed using SPSS 17.0 software. Results After 3 months and 6 months, the trial group had lower scores of the total score of quality of life, psycho-social domain, and motive and energy dimension than those of the control group (Plt;0.05). After 6 months, the trial group had lower scores of mental disability and social function (Plt;0.05) but a higher score of family social care index (Plt;0.05). The scores of WHO-DSA II and SQLS were positively correlated, while the scores of APGAR and SQLS were negatively correlated. Conclusion The integral mode of hospital-community-family mental rehabilitation effectively improves the quality of life of patients with schizophrenia, which also positively improves patients’ rehabilitation.
ObjectiveTo explore the effects of drug management skill training on lightening the family burden of schizophrenic patients in their recovery period. MethodsBetween December 2011 and December 2013, 101 patients with schizophrenia were randomly divided into experimental group (n=56) and control group (n=45). The experimental group was given drug management skill training, while the control group only received routine follow-up. The course of the research was six months. Both groups were assessed by the positive and negative syndrome scale on patients' psychological symptoms, and family burden scale of diseases was used to assess the burden of the family. ResultsCompared with the controls, patients in the experimental group improved more in their positive symptoms (t=2.692, P=0.008), negative symptoms (t=2.729, P=0.008), general psychopathology symptoms (t=3.231, P=0.002) and the whole psychiatric symptoms (t=3.870, P<0.001). Moreover, the degree of patients' symptom improvement was positively correlated with the degree of family burden lightening (r=0.44, P<0.001). ConclusionFor patients with schizophrenia, reasonable drug management skill training can effectively improve patients' medication compliance, promote treatment effect and lighten family burden.
Objective To investigate the difference in first onset age, family history and medication compliance between male and female patients with schizophrenia in communities. Methods We used self-designed questionnaire to survey and analyze 372 cases of schizophrenia between June to August 2014. Results There were no significant differences between male and female schizophrenic patients in the family history, personality before the disease, education level, age, and the onset type and disease course (P > 0.05). The first onset age of male patients [(24.92±8.22) years] was significantly earlier than female patients [(27.02±11.28) years] and the difference was statistically significant (P < 0.05). The number of unmarried male patients (115, 58.97%) was significantly more than unmarried females (81, 45.76%) and the difference was statistically significant (P < 0.05). The full medication compliance rate of female patients (127, 71.75%) was significantly better than that of male patients (115, 58.97%) (P < 0.05). Conclusion The first onset age, marital status and medication compliance are significantly different between the two genders of patients with schizophrenia, which indicates that prevention, treatment and recovery measures for male and female patients should be differentiated.
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM-IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 1:1.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥ 38, ≥ 45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score ≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (Plt;0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.