用药态度对精神分裂症患者治疗依从性和症状影响的1年随访研究

发布时间：2018-03-06 15:52

本文选题：精神分裂症　切入点：整合治疗　出处：《中国神经精神疾病杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨精神分裂症整合治疗(心理社会干预合并药物治疗)的疗效,分析不同干预方式中用药态度对治疗依从性和精神症状的影响,探讨整合治疗疗效机制。方法 2012年至2015年间纳入170例精神分裂症患者,随机分为整合治疗组(86例)和常规药物治疗组(84例),整合治疗组给予常规药物治疗合并心理社会干预,常规药物治疗组仅给予常规药物治疗,入组3个月、6个月和12个月随访,分别采用用药态度量表(drug attitude inventory,DAI)、自知力问卷(self-awareness inventor,SAI)—治疗依从性量表、阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评估用药态度、治疗依从性、临床精神病性症状。结果随访12月时,整合治疗组PANSS阳性症状和一般精神症状量表减分、DAI和SAI治疗依从性增分均高于药物治疗组(均P0.05),整合治疗组药物依从率高于药物治疗组(72.1%vs.45.2%,P0.01)。常规药物治疗组PANSS总分减分与DAI的增分呈正关联(β=0.31,P=0.02),且治疗依从性的改善中介二者之间的关系(β=0.18,P=0.18);而整合治疗组患者中,未发现DAI增分与PANSS总分减分之间的相关关系(P0.05),SAI—治疗依从性的增分与PANSS量表的阳性症状量表减分(r=0.31,P=0.01)和一般精神症状量表的减分(r=0.36,P0.01)呈正相关。结论本研究表明常规药物治疗组中,用药态度通过提高治疗依从性来改善精神性症状,整合治疗症状改善与治疗依从性改善有关,与用药态度可能无关。
[Abstract]:Objective to explore the effect of integrated therapy for schizophrenia (psycho-social intervention combined with drug therapy), and to analyze the effect of medication attitude on compliance and mental symptoms in different intervention methods. Methods from 2012 to 2015, 170 patients with schizophrenia were randomly divided into integrated treatment group (n = 86) and routine drug treatment group (n = 84). The routine drug therapy group was treated with routine drug therapy only, followed up for 3 months, 6 months and 12 months into the group. The drug attitude inventory and DAI were used respectively, and the self-awareness inventory SAII-therapeutic compliance scale was used respectively. The positive and negative syndrome scale (PANSSs) was used to assess drug use attitude, therapeutic compliance, and clinical psychiatric symptoms. The scores of PANSS positive symptoms and general psychiatric symptoms decreased by Dai and SAI were higher in the integrated treatment group than in the drug treatment group (all P 0.05). The drug compliance rate in the integrated treatment group was higher than that in the drug treatment group. The total score of PANSS in the routine drug treatment group was higher than that in the drug treatment group (72.1 vs.45.2). There was a positive correlation between the decreasing score and the increasing score of DAI (尾 -0.31), and the relationship between the improvement of therapeutic compliance (尾 -0.18) and the increase of DAI (尾 -0.18), but in the integrated treatment group, There was no positive correlation between the increase of DAI score and the total score of PANSS. Conclusion this study shows that there is a positive correlation between the increased score of DAI and the score of SAI- and the subtractive score of the positive symptom scale of PANSS and the subtractive score of general psychiatric symptom scale 0.36% P0.01.Conclusion in the routine drug therapy group, there is a positive correlation between the increased score of SAI- and the subtractive score of the positive symptom scale of PANSS and the subtractive score of the general psychiatric symptom scale. Drug use attitude can improve mental symptoms by improving treatment compliance, integration treatment symptom improvement is related to treatment compliance improvement, and it may not be related to medication attitude.
【作者单位】：广州市惠爱医院广州医科大学附属脑科医院;北京师范大学心理学部;
【基金】：国家自然科学基金(编号:81671334) 广州市科技计划项目(编号:2014Y2-00105) 国家科技支撑计划(编号:2015BAI13B02)
【分类号】：R749.3

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