慢性精神分裂症社会技能训练的研究

关键词：精神分裂症  社会技能训练  康复

Keywords:schizophrenia  social skills training  rehabilitation

摘要：

      摘要 目的：探讨社会技能训练对慢性精神分裂症患者社会功能与生存质量的影响。方法：对象取自无锡市4个街道中病程5年以上的精神分裂症患者113例。随机分配到社会技能训练组（以下简称“训练组”）50例和对照组63例。对训练组按顺序进行药物处置能力训练、社交技能训练、职业培训和俱乐部活动。全疗程13个月。结果：社会技能训练前两组的精神症状、住院率、肇事率、社会功能和生存质量满意度差异无显著性意义。治疗期间训练组住院次数、住院天数和肇事率都显著低于对照组（分别为：t=3.358，P<0.01；t=2.954，P<0.01；t=2.891，P<0.01）。训练组的PANSS总分明显低于对照组（t=3.300，P<0.001），其中阴性症状分和一般病理症状分都显著低于对照组（分别为：t=3.272，P<0.001；t=3.123，P<0.01；），阳性症状分差异无显著性。治疗后训练组的SDSS分显著低于对照组（t=2.106，P<0.05），GAF分显著高于对照组（t=2.154，P<0.05）。训练组WHOQOL-BREF总分及4个单项分均显著高于对照组。回归分析显示，GAF分与参加训练次数呈正相关（R=0.2891，F=4.3788，P=0.0417）。结论：社会技能训练能改善慢性精神分裂症患者的精神症状、社会功能和生存质量，降低或延缓精神残疾，降低复发率和肇事率，是当前较为有效的精神康复措施。 关键词 精神分裂症；社会技能训练；康复 中图分类号：R749.3, R49 文献标识码：A 文章编号：1001-1242(2008)-03-0241-04

Abstract:

      Objective:To explore the effects of social skills training for chronic schizophrenic patients. Method:A total of 113 chronic schizophrenic patients with above 5 years courses in community were randomly assigned to two groups, 50 patients in social skills training group （training group） and 63 patients in control group. The social skills training time for patients in training group was 13 months. The integrated treatment included medicine-problem-solving skills, social communication training and vocational skills training. Result:Fifty patients in training group fulfilled social skills training program. There was no significant difference in demography, symptoms and frequency of administrated hospital and causing trouble between two groups. During social skills training program, the frequency and time of administrated hospital and causing trouble in training group was significantly lower than control group （t=3.358，P<0.01；t=2.954，P<0.01； t=2.891，P<0.01 respectively.）The scores of PANSS in training group after social skills training were significantly lower than that in control group（t= 3.300，P<0.001）.The scores of SDSS in training group after social skills training were lower than that in control group（t= 2.106，P<0.05）. The scores of GAF in training group increased significantly than that in control group（t= 2.154，P<0.05）. The total score of WHOQOL-BREF and its four sub-scale in training group were significantly higher than that in control group. Regression analysis confirmed positive relation between the score of GAF and participating frequency in training group (P=0.0417). Conclusion:Social skills training had positive effects on the rehabilitation of chronic schizophrenic patients. The mental symptoms, social function and quality of life improved in these patients after treatment. The frequency of mental disability reduced in schizophrenia patients.The frequency of relapse and causing trouble in patients reduced also.