PSYCHIATRIC SYMPTOMS AND DISABILITIES AMONG THE PATIENT WITH CHRONIC SCHIZOPHRENIA.

研究对象是159名与我们的精神健康服务有联系的患者，该服务于1965年在群马县的Sakai-machi开始。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，没有接受任何治疗，3人因困难需要治疗。到1996年10月随访时，门诊病人56例，住院病人45例，病情较好10例，需治疗4例，死亡31例，外迁6例。9年间门诊与住院患者的比例相对稳定。对该镇89名存活患者进行了PANSS（阳性和阴性症状量表）和LSP（生活技能概况）评估。PANSS阳性量表平均分14.4分，阴性量表平均分18.9分，综合精神病理学量表平均分33.3分，LSP总分平均分129.4分，自我照顾分31.1分，无焦虑分45.2分，焦虑分15分。社会交往0分，沟通20.1分，责任17.7分。不同性别、年龄组的心理健康状况对消极量表总分无显著影响，但在社会适应方面存在显著差异，消极量表与心理健康状况总分之间也存在显著相关（Pearson's系数r=-0.73，P <0.0001）。其中，自我照顾、社会交往和沟通与负性量表得分相关，在个案研究中，我们注意到负性量表与LSP得分之间存在矛盾关系的个案。有些病例虽然症状严重，但仍能改善其残疾，因此可能会有有益的建议。我们讨论了这些结果与国际损伤，残疾和障碍分类。

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.