Ran Mao-Sheng, Xiang Meng-Ze, Chan Cecilia Lai-Wan, Leff Julian, Simpson Peggy, Huang Ming-Sheng, Shan You-He, Li Si-Gan
Institute of Mental Health, West China Hospital, West China University of Medical Sciences, Chengdu, China.
Soc Psychiatry Psychiatr Epidemiol. 2003 Feb;38(2):69-75. doi: 10.1007/s00127-003-0601-z.
The aim of this study was to explore the characteristics and efficacy of psychoeducational family intervention for persons with schizophrenia in rural China.
A cluster randomised controlled trial of psychoeducational family intervention for families experiencing schizophrenia (three groups, 326 cases) was conducted in Xinjin County, Chengdu. Treatment groups consisted of family intervention and medication, medication alone, and a control.
The results showed a gain in knowledge, a change in the relatives' caring attitudes towards the patients, and an increase in treatment compliance in the psychoeducational family intervention group (p < 0.05, 0.001). Most importantly, the relapse rate over 9 months in this group (16.3 %) was half that of the drug-only group (37.8 %), and just over one-quarter of that of the control group (61.5 %) (p < 0.05). Antipsychotic drug treatment and families' attitudes towards patients after the 9-month follow-up were significantly associated with clinical outcome (p < 0.05).
In rural China, family intervention should focus on improving the relatives' recognition of illness, the caring attitude towards the patients, treatment compliance, relapse prevention, and the training of the patients' social functioning. This trial, one of the largest in the literature, has shown that psychoeducational family intervention is effective and suitable for psychiatric rehabilitation in Chinese rural communities.
本研究旨在探讨中国农村地区精神分裂症患者心理教育家庭干预的特点及效果。
在成都新津县对患有精神分裂症的家庭进行了心理教育家庭干预的整群随机对照试验(三组,326例)。治疗组包括家庭干预加药物治疗、单纯药物治疗和对照组。
结果显示,心理教育家庭干预组患者的知识有所增加,亲属对患者的关爱态度有所改变,治疗依从性有所提高(p<0.05,0.001)。最重要的是,该组9个月的复发率(16.3%)是单纯药物治疗组(37.8%)的一半,仅为对照组(61.5%)的四分之一多一点(p<0.05)。9个月随访后的抗精神病药物治疗及家庭对患者的态度与临床结局显著相关(p<0.05)。
在中国农村地区,家庭干预应侧重于提高亲属对疾病的认识、对患者的关爱态度、治疗依从性、预防复发以及患者社会功能的训练。本试验是文献中规模最大的试验之一,表明心理教育家庭干预有效且适用于中国农村社区的精神康复。