Department of Social Science, Health and Medicine, School of Social Science and Public Policy, King's College, University of London, London, UK.
Psychiatry Clin Neurosci. 2013 Sep;67(6):384-96. doi: 10.1111/pcn.12071. Epub 2013 Jul 25.
The aim of the present study is to clarify the influence of deinstitutionalization on discharged long-stay patients based on a review of recently published literature. English-language studies were searched from PubMed and Embase for the years 2000-2012, with the terms 'long-stay' or 'chronic mentally ill' and 'deinstitutionalis(z)ation' or 'community' or 'discharged' in the title and/or abstract. The present study defined long-stay as hospitalization >6 months. A total of 14 articles were identified. The majority of the participants suffered from schizophrenia. The most frequently assessed outcomes were social functioning, psychiatric symptoms and quality of life (QOL)/participant attitudes towards the environment. For social functioning, most of the studies found favorable changes. As regards psychiatric symptoms, stability or at least some improvements were detected. For QOL/participant attitudes towards the environment, positive changes, at least at some time-points, were noted. Significant deterioration was rare in all of the three outcomes. The majority of the participants showed enhancements in social functioning despite the fact that functional impairment is common in persons with schizophrenia, which indicates that even long-stay patients could achieve better functioning by deinstitutionalization. Although the stability in symptoms might be due to continuous schizophrenia course, moving to the community may also lead to improvement. The favorable changes in QOL/participants' attitudes towards the environment are in line with other studies.
本研究旨在通过对近期发表的文献进行综述，阐明去机构化对出院长期住院患者的影响。检索了 2000 年至 2012 年间 PubMed 和 Embase 中的英文研究，使用的术语包括“长期住院”或“慢性精神疾病”和“去机构化”或“社区”或“出院”，出现在标题和/或摘要中。本研究将长期住院定义为住院时间>6 个月。共确定了 14 篇文章。大多数参与者患有精神分裂症。评估最多的结果是社会功能、精神症状和生活质量（QOL）/参与者对环境的态度。对于社会功能，大多数研究发现有良好的变化。至于精神症状，发现稳定或至少有一些改善。对于 QOL/参与者对环境的态度，至少在某些时间点，都有积极的变化。在所有三个结果中，很少出现显著恶化。尽管精神分裂症患者通常存在功能障碍，但大多数参与者的社会功能都有所增强，这表明即使是长期住院的患者也可以通过去机构化获得更好的功能。尽管症状的稳定性可能是由于持续的精神分裂症病程，但搬入社区也可能导致症状的改善。QOL/参与者对环境态度的有利变化与其他研究一致。
