Chatterjee Sudipto, Patel Vikram, Chatterjee Achira, Weiss Helen A
Latrobe Regional Hospital, Traralgon Victoria, Australia.
Br J Psychiatry. 2003 Jan;182:57-62. doi: 10.1192/bjp.182.1.57.
There are no community services for the majority of the estimated 10 million persons with schizophrenia in India. Community-based rehabilitation (CBR) is a model of care which has been widely used for physical disabilities in resource-poor settings.
To compare CBR with out-patient care (OPC) for schizophrenia in a resource-poor setting in India.
A longitudinal study of outcome in patients with chronic schizophrenia contrasted CBR with OPC. Outcome measures were assessed using the Positive and Negative Symptom Scale and the modified WHO Disability Assessment Schedule at 12 months.
Altogether, 207 participants entered the study, 127 in the CBR group and 80 in the OPC group. Among the 117 fully compliant participants the CBR model was more effective in reducing disability, especially in men. Within the CBR group, compliant participants had significantly better outcomes compared with partially compliant or non-complaint participants (P<0.001). Although the subjects in the CBR group were more socially disadvantaged, they had significantly better retention in treatment.
The CBR model is a feasible model of care for chronic schizophrenia in resource-poor settings.
在印度，估计有1000万精神分裂症患者，其中大多数人无法获得社区服务。基于社区的康复（CBR）是一种护理模式，已在资源匮乏地区广泛用于身体残疾者。
在印度资源匮乏地区，比较CBR与精神分裂症门诊护理（OPC）。
一项针对慢性精神分裂症患者结局的纵向研究，对比了CBR与OPC。在12个月时，使用阳性和阴性症状量表以及修订版世界卫生组织残疾评定量表评估结局指标。
共有207名参与者进入研究，CBR组127人，OPC组80人。在117名完全依从的参与者中，CBR模式在减少残疾方面更有效，尤其是在男性中。在CBR组内，依从的参与者比部分依从或不依从的参与者结局明显更好（P<0.001）。尽管CBR组的受试者社会处境更不利，但他们的治疗保留率明显更高。
CBR模式是资源匮乏地区慢性精神分裂症可行的护理模式。
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