标题：基于疾病进展需求差异化的阶段性心理支持联合抗精神药物对住院精神分裂症患者康复效果的影响

      作者：蔡钱婷，李玉华，常芸    上海市宝山区精神卫生中心精神科，上海 201901

      卷次： 2023年34卷24期

      【摘要】 目的 探究基于疾病进展需求差异化的阶段性心理支持联合抗精神药物对住院精神分裂症患者康复效果的影响。方法 选取2020年6月至2021年6月上海市宝山区精神卫生中心收治的95例精神分裂症患者作为研究对象，依据入院时间先后分为对照组46例和观察组49例。两组患者入院后均接受2个月干预，其中对照组接受常规抗精神药物干预，观察组接受基于疾病进展需求差异化的阶段性心理支持联合抗精神药物干预。比较两组患者干预前后的精神症状[阳性与阴性症状量表(PANSS)]、认知功能[蒙特利尔认知评估量表(MoCA)]、社会功能[个人与社会表现量表(PSP)]和生活质量[精神分裂症患者生活质量量表(SQLS)]。结果 干预前，两组患者PANSS量表中的各项评分及总分比较差异均无统计学意义(P>0.05)；干预后两组患者的阳性症状评分、一般精神病理症状评分以及总分明显低于干预前，且观察组干预后的阴性症状评分、一般精神病理症状评分、总分明显低于对照组，差异均有统计学意义(P<0.05)，但两组患者干预后的阳性症状评分比较差异无统计学意义(P>0.05)；干预后，观察组患者MoCA评分和 PSP评分分别为(18.24±4.28)分、(79.54±6.01)分，明显高于对照组的(15.19±3.63)分、(72.27±5.58)分，差异均有统计学意义(P<0.05)；干预后，观察组患者SQLS量表心理社会、动力和精力、症状和副作用评分分别为(21.38±5.14)分、(19.26±4.35)分、(18.76±4.06)分，明显低于对照组的(24.57±5.18)分、(22.03±4.26)分、(21.42±4.51)分，差异均有统计学意义(P<0.05)。结论 采用基于疾病进展需求差异化的阶段性心理支持联合抗精神药物可显著改善患者的精神分裂症症状、认知功能和社会功能，同时可提高患者生活质量。
      【关键词】 精神分裂症；抗精神药物；阶段性心理支持技术；精神症状；认知功能；社会功能；生活质量
      【中图分类号】 R473.74 【文献标识码】 A 【文章编号】 1003—6350（2023）24—3631—05

Impact of phased psychological support based on demand differentiation caused by disease progression combinedwith antipsychotic drugs on rehabilitation effect of inpatients with schizophrenia.
CAI Qian-ting, LI Yu-hua,CHANG Yun. Department of Psychiatry, Shanghai Baoshan District Mental Health Center, Shanghai 201901, CHINA
【Abstract】 Objective To investigate the impact of phased psychological support based on demand differentia-tion caused by disease progression combined with antipsychotic drugs on rehabilitation effect of inpatients with schizo-phrenia. Methods A total of 95 patients with schizophrenia admitted to Shanghai Baoshan District Mental Health Centerfrom June 2020 to June 2021 were selected as the research subjects. According to the time of admission, they were dividedinto a control group (46 cases) and an observation group (49 cases). All patients received 2 months of intervention after ad-mission. The control group received routine antipsychotic drug intervention, and the observation group received phasedpsychological support based on demand differentiation caused by disease progression combined with antipsychotic drug in-tervention. Mental symptoms [Positive and Negative Syndrome Scale (PANSS)], cognitive function [Montreal CognitiveAssessment (MoCA)], social function [Personal and Social Performance (PSP)], and quality of life [Schizophrenia Qualityof Life Scale (SQLS)] before and after intervention were compared between the two groups. Results Before interven-tion, there was no statistically significant difference in the score for each item in the PANSS or the total score betweenthe two groups (P>0.05). After intervention, the positive symptom scores, general psychopathological symptom scores,and total scores of both groups decreased significantly, and negative symptom scores, general psychopathological symp-tom scores, and total scores of the observation group were significantly lower than those of the control group, with statis-tically significant differences (P<0.05). There was no statistically significant difference in positive symptom scores be-tween the two groups after intervention (P>0.05). After intervention, MoCA score and PSP score in the observationgroup were (18.24±4.28) points and (79.54±6.01) points, which were significantly higher than (15.19±3.63) points and(72.27±5.58) points in the control group (P<0.05). After intervention, the scores for psycho-social factor, motivation and en-ergy, symptoms and side effects in the SQLS in the observation group were (21.38±5.14) points, (19.26±4.35) points, and(18.76±4.06) points, which were significantly lower than (24.57±5.18) points, (22.03±4.26) points, and (21.42±4.51) pointsin the control group (P<0.05). Conclusion Phased psychological support based on demand differentiation caused bydisease progression combined with antipsychotic drugs can significantly improve symptoms, cognitive function, socialfunction of patients with schizophrenia, and improve the quality of life of patients.
      【Key words】 Schizophrenia; Antipsychotic drug; Phased psychological support; Mental symptoms; Cognitivefunction; Social function; Quality of life