Thornicroft Graham, Tansella Michele, Becker Thomas, Knapp Martin, Leese Morven, Schene Aart, Vazquez-Barquero José Luis
Section of Community Psychiatry, Health Services Research Department, Institute of Psychiatry, Kings College London, De Crespigny Park, London SE5 8AF, UK.
Schizophr Res. 2004 Aug 1;69(2-3):125-32. doi: 10.1016/s0920-9964(03)00191-9.
The personal impact of schizophrenia is poorly described in the scientific literature. The European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) study compared representative treated prevalence cohorts of patients with schizophrenia in five European countries, to assess unmet needs, impact on caregivers, quality of life, satisfaction with services, symptoms and disability. Of the 404 patients, 79% undertook no work of any kind, and 65% were single. Low quality of life was associated with: anxiety, depression, psychotic symptoms, more previous psychiatric admissions, alcohol abuse, having no reliable friends nor daily contact with family, being unemployed, and having few leisure activities. The most frequently occurring unmet needs among the patients were: daytime activities, company and intimate relationships, psychotic symptoms, psychological distress, and information. The most common worries of relatives were about the patient's health, and their own future, safety and financial position. Psychiatric services were therefore largely ineffective in managing the personal impact of schizophrenia, especially upon work, home and family life. Research, clinical practice and disability policy developments need to address a wider range of consequences of the disorder than symptoms alone.
精神分裂症对个人的影响在科学文献中鲜有描述。欧洲精神科服务：与结果领域及需求相关的投入（EPSILON）研究比较了五个欧洲国家中接受治疗的精神分裂症患者的代表性患病率队列，以评估未满足的需求、对照料者的影响、生活质量、对服务的满意度、症状及残疾情况。在404名患者中，79%没有从事任何工作，65%为单身。生活质量低下与以下因素相关：焦虑、抑郁、精神病症状、既往更多次的精神科住院、酒精滥用、没有可靠的朋友且与家人无日常联系、失业以及几乎没有休闲活动。患者中最常出现的未满足需求是：日间活动、陪伴及亲密关系、精神病症状、心理困扰以及信息。亲属最常见的担忧是患者的健康以及他们自己的未来、安全和经济状况。因此，精神科服务在应对精神分裂症对个人的影响方面大多无效，尤其是对工作、家庭和家庭生活的影响。研究、临床实践和残疾政策制定需要关注该疾病比症状本身更广泛的一系列后果。
