Jaracz Krystyna, Górna Krystyna, Kiejda Justyna, Rybakowski Janusz
Zakład Pielegniarstwa Neurologicznego i Psychiatrycznego AM w Poznaniu.
Psychiatr Pol. 2008 Jan-Feb;42(1):33-46.
To evaluate prospectively the course of schizophrenia in men and women after a first psychiatric hospitalization in terms of socio-vocational situation, social functioning and psychopathological status.
A study sample consisted of 74 patients (46 males, 28 females), examined 1 month (T. 1), 13 months (T. 2) after a discharge, and 4-6 years after T. 1 (T.3). The research instruments were: a questionnaire for socio-demographic data and information about the illness course, Social Functioning Scale (SFS) and PANSS.
During the follow-up period, the socio-vocational situation and psychopathological status has worsened. The percentage of patients unemployed or not studying increased by 26%, whilst those receiving a disability pension by 50%. Despite of the pharmacological treatment, symptoms severity increased, particularly in the group of negative symptoms and general psychopathology (p < 0.01). Social functioning showed a significant trend to improve but only in some domains. Between T. 1 and the last follow-up, there was an increase in total SFS and in 3 out of the 7 domains. This improvement was particularly noticeable in the group of female patients hospitalized before the age of 20 years (p < 0.05). Female patients, regardless of age of their first hospitalization, scored higher in the Independence performance domain.
(1) The early course of schizophrenia appears to be heterogeneous. This was reflected by the deterioration of socio-vocational situation and psychopathological status, and by a variability of the changes in social functioning. (2) This heterogeneity and non-parallel changes should be taken into account when planning and evaluating therapeutic interventions. (3) The early course of schizophrenia seems to be more beneficial for female patients.
前瞻性评估首次精神科住院后男性和女性精神分裂症患者在社会职业状况、社会功能和精神病理状态方面的病程。
研究样本包括74例患者（46例男性，28例女性），分别在出院后1个月（T.1）、13个月（T.2）以及T.1后的4 - 6年（T.3）进行检查。研究工具包括：社会人口统计学数据和疾病病程信息问卷、社会功能量表（SFS）和阳性与阴性症状量表（PANSS）。
在随访期间，社会职业状况和精神病理状态恶化。失业或未上学的患者比例增加了26%，而领取残疾抚恤金的患者比例增加了50%。尽管进行了药物治疗，但症状严重程度仍增加，尤其是在阴性症状和总体精神病理学组中（p < 0.01）。社会功能显示出显著的改善趋势，但仅在某些领域。在T.1和最后一次随访之间，SFS总分及7个领域中的3个领域有所增加。这种改善在20岁前住院的女性患者组中尤为明显（p < 0.05）。无论首次住院年龄如何，女性患者在独立表现领域得分更高。
（1）精神分裂症的早期病程似乎具有异质性。这反映在社会职业状况和精神病理状态的恶化以及社会功能变化的可变性上。（2）在规划和评估治疗干预措施时，应考虑到这种异质性和非平行变化。（3）精神分裂症的早期病程似乎对女性患者更有利。
