PSYCHIATRIC SYMPTOMS AND DISABILITIES AMONG THE PATIENT WITH CHRONIC SCHIZOPHRENIA.

研究对象为159名曾与我们的心理健康服务有过接触的患者，该服务始于1965年，位于群马县酒井町。截至1987年3月，159名病人中有59人在门诊部就诊，51人在精神病院，13人情况良好，没有任何治疗，3人因困难而需要治疗。1996年10月随访，门诊56例，住院45例，病情良好10例，需治疗4例，死亡31例，外迁6例。9年间门诊患者与住院患者的比例相对稳定。对该镇89名活着的患者进行访谈，以评估阳性和阴性症状量表(PANSS)和生活技能量表(LSP)。PANSS总分平均为129.4分，其中自理31.1分，无骚动45.2分，社交15.0分，人际交往2 0.1分，责任心17.7分。这些得分不受性别和年龄差异的影响，但在社会适应结果方面存在显著差异，负性得分与社会适应总分之间也存在显著的相关性(P&lt；0.0001)。在各分量表中，自我照顾、社交和沟通与负性量表得分相关。在个案研究中，我们注意到其负性维度与LSP得分之间存在矛盾关系的特殊情况。可能会有一些有用的建议，因为一些病例尽管症状严重，但仍能改善他们的残疾。我们参考《国际损伤、残疾和残障分类》讨论了这些结果。

The subjects were 159 patients who had contact with our mental health service which began in 1965 in Sakai-machi, Gunma-ken. 59 of 159 patients were attending outpatient clinics, 51 were in mental hospitals, 13 were in good condition without any treatment and 3 need treatment for difficulties in March 1987. By our follow-up study in October 1996, it was found that 56 of them were outpatients, 45 were inpatients, 10were in good condition, 4 needing treatment, 31 were dead and 6 had moved out of the town. The proportion of outpatients to inpatients was relatively stable during 9 years.89 of alive patients in the town were interviewed to assess the PANSS (Positive and negative syndrome scale) and the LSP (Life skills profile). The average score of Positive scale was 14.4, Negative scale was 18.9 and Comprehensive psychopathology scale was 33.3 in the PANSS.The average of total LSP score was 129.4 and the subscale score were 31.1 in Self-care, 45.2 in Non-turbulence, 15.'0 in Social contact, 20.1 in Communication and 17.7 in Responsibility. These scores were not affected by the difference of sex and age groups, but there were significant differences concerning the outcomes of social adaptation.There were also strong correlation (Pearson's coefficient r=-0.73, P<0.0001) between Negative scale and total LSP score. Among the subscales, Self-care, Social contact and Communication associated with Negative scale score.In case study, we paid attention to the exceptional cases that have paradoxical relationship between their Negative scale and LSP score. There might be helpful suggestions because some of the cases were able to improved their disablities in spite of the severe symptoms. We discussed these results refering to the International Classification of Impairment, Disability and Handicaps.