Six-month outcome following a relapse of schizophrenia
Six-month outcome following a relapse of schizophrenia
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DOI：
10.3109/00048679809073871
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发表时间：
1998-12-01
影响因子：
4.6
通讯作者：
Bashir, M
中科院分区：
文献类型：
--
作者：
Bergen, J;Hunt, G;Bashir, M
目的：分析精神分裂症患者入院急性护理时和 6 个月后的临床数据，以确定与频繁住院和不良预后相关的因素。方法：从医院或社区 24 小时危机小组连续入院急性护理的 99 名精神分裂症患者的病历中收集信息，并进行为期 6 个月的前瞻性研究。结果：四分之一的患者在上次出院后 3 个月内接受急性护理，并且仅34 名患者在入院前 3 个月遵守了精神安定药物治疗。 21 名患者完全由危机小组管理，27 名患者仅接受住院护理，其余 (n = 51) 接受两种类型的急性护理。入院六个月后，42 名患者已出院，不需要进一步的急性护理，29 名患者至少再次入院一次，3 名患者已转入住院康复科，因此整个期间均留在医院。其余 25 名患者中，一名患者在出院 2 个月后自杀，其他患者在 2 个月和/或 6 个月的随访中无法与社区心理健康团队取得联系。结论：本研究中确定的与复发相关的一些因素是不遵守药物治疗、压力、社会支持不足和药物滥用。频繁复发的患者预后不佳，强调需要减少精神分裂症症状的发生，以提供更好的生活质量。 25% 的患者在复发后很快就不再接受治疗，这表明应该采取更多措施让这些人参与长期治疗计划。
Objective: To analyse clinical data on patients with schizophrenia on admission to acute care and 6 months later in order to identify factors associated with frequent hospitalisations and poor outcome.Method: Information was collected from the medical records of 99 patients with schizophrenia consecutively admitted to acute care in hospital or by community based 24 h Crisis Teams and prospectively studied for 6 months.Results: One-quarter of patients were being admitted to acute care within 3 months of their last hospital discharge and only 34 patients were compliant with their neuroleptic medication 3 months prior to the index admission. Twenty-one patients were managed entirely by the Crisis Teams, 27 patients received inpatient care only and the remainder (n = 51) had both types of acute care. Six months after admission, 42 patients had been discharged and did not require further acute care, 29 patients had been re-admitted at least once and three patients had been transferred to an inpatient rehabilitation unit and, therefore, remained in hospital over the entire period. Of the remaining 25 patients, one committed suicide 2 months after discharge and the other patients were not contactable by Community Mental Health Teams at the 2 and/or 6 month follow up.Conclusions: Some of the factors associated with relapse identified in the present study were non-compliance with medication, stress, inadequate social support and substance abuse. The poor outcome in patients with frequent relapses emphasises the need to reduce the occurrences of schizophrenic symptoms to provide a better quality of life. The 25% of patients dropping out of care soon after a relapse indicates that more should be done to engage these people in long-term treatment programs.