PSYCHIATRIC SYMPTOMS AND DISABILITIES AMONG THE PATIENT WITH CHRONIC SCHIZOPHRENIA.

研究对象为1965年开始在群马县酒井町接受心理健康服务的159名患者。1987年3月，159名病人中有59人在门诊就诊，51人在精神病院，13人情况良好，但未接受任何治疗，3人因困难需要治疗。通过1996年10月的跟踪调查，我们发现其中56人是门诊病人，45人是住院病人，10人情况良好，4人需要治疗，31人死亡，6人已迁出该镇。9年间，门诊患者占住院患者的比例相对稳定。对89名在世患者进行访谈，评估PANSS（阳性和阴性综合征量表）和LSP（生活技能概况）。PANSS阳性量表平均得分为14.4分，阴性量表平均得分为18.9分，综合精神病理量表平均得分为33.3分。LSP总分的平均值为129.4分，Self-care量表得分31.1分，Non-turbulence量表得分45.2分，15分。社会接触得分0分，沟通得分20.1分，责任得分17.7分。这些得分不受性别和年龄组差异的影响，但在社会适应结果方面存在显著差异。负量表与LSP总评分之间也有很强的相关性（Pearson系数r=-0.73， P<0.0001）。其中，自我照顾、社会接触和沟通与负量表得分相关。在案例研究中，我们关注了负面量表与LSP评分之间存在矛盾关系的例外案例。可能会有一些有益的建议，因为一些病例能够改善他们的残疾，尽管严重的症状。我们参照国际损伤、残疾和残障分类来讨论这些结果。

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.