目的 探讨改良式"重返社区技能训练"对社区精神分裂症患者症状、认知及社会功能的干预效果.方法 选取2014年5月—2015年4月在北京市丰台区精神卫生管理系统中登记且由丰台社区卫生服务中心辖管的精神分裂症患者162例为研究对象,随机分为对照组(n=82)与干预组(n=80).对照组患者接受单纯药物治疗;干预组在对照组的基础上接受改良式"重返社区技能训练".干预时间为12个月.干预前和干预12个月时,分别采用阳性和阴性症状量表(PANSS)、自知力与治疗态度问卷(ITAQ)、社会功能缺陷筛选量表(SDSS)评估患者的精神症状、认知功能及社会功能等.结果 干预期间,9例患者失访,最终纳入对照组77例,干预组76例.干预前,两组患者PANSS、ITAQ、SDSS评分比较,差异无统计学意义(P>0.05).干预12个月时,两组阳性症状评分、一般精神病理症状评分比较,差异无统计学意义(P>0.05);两组患者阴性症状评分、PANSS总分、ITAQ评分、SDSS评分比较,差异有统计学意义(P<0.05).结论 在药物治疗的基础上,改良式"重返社区技能训练"能有效改善社区精神分裂症患者的症状、提高患者认知能力及社会功能.%Objective To explore the intervention effects of improved social skills training for community reentry on symptoms, cognition and social functioning of community schizophrenia patients. Methods From Fengtai Community Health Service Center, 162 chronic schizophrenia patients enrolled in Beijing Mental Health Management System were selected from May 2014 to April 2015, and they were randomly divided into the control group (n=82) and the intervention group (n=80). Patients in the control group received medication treatment only, while besides medication treatment, patients in the intervention group also accepted social skills training for community reentry. The intervention lasted for 12 months. The Positive and Negative Symptom Scale (PANSS), Insight and Treatment Attitude Questionnaire (ITAQ) and Social Function Defect Screening Scale (SDSS) were adopted to assess symptoms, cognition and social functioning of schizophrenia patients before intervention and after 12-month intervention. Results During the intervention period, nine patients were lost to follow-up and eventually, there were 77 patients in the control group and 76 patients in the intervention group. Before intervention, there were no significant differences in the scores of PANSS, ITAQ and SDSS between two groups (P>0.05). After 12-month intervention, there were no significant differences in the scores of positive symptom and general psychopathological symptom between two groups (P>0.05). However, there were significant differences in the scores of negative symptom, PANSS, ITAQ and SDSS between two groups (P<0.05). Conclusion On the basis of medication treatment, the improved social skills training for community reentry can effectively improve the symptoms, cognition and social functioning of community schizophrenia patients.
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