1 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong.
2 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Int J Soc Psychiatry. 2017 May;63(3):203-211. doi: 10.1177/0020764017692840. Epub 2017 Mar 7.
Little is known about whether family economic status might influence the long-term (e.g. over 10 years) outcome of persons with schizophrenia in the community.
To examine the differences in outcome at 14-year follow-up of persons with schizophrenia from high versus low family economic status backgrounds in a Chinese rural area.
A prospective 14-year follow-up study was conducted in six townships in Xinjin County, Chengdu, China. All participants with schizophrenia ( n = 510) were identified in an epidemiological investigation of 123,572 people aged 15 years and older and followed up from 1994 to 2008.
Individuals from low family economic status (<mean) in 1994 had significantly higher rate of homelessness (9.9%) and lower rate of survival (63.8%) in 2008 than those from high family economic status (⩾mean; 3.2% and 76.6%, respectively). Individuals from low family economic status had significantly lower rates of marriage and complete remission, higher mean scores on Positive and Negative Syndrome Scale (PANSS) and lower mean score on Global Assessment of Functioning (GAF) than those from high family economic status in 2008. The predictors of low family economic status of individuals in 2008 encompassed the baseline low family economic status, poor families' attitude toward the patient, younger age, older age of first onset and longer duration of illness.
Low family economic status is a predictive factor of poor long-term outcome of persons with schizophrenia in the rural community. Individuals' family economic status should be considered in making mental health policy and providing community-based mental health services.
关于家庭经济状况是否会影响社区中精神分裂症患者的长期(例如 10 年以上)预后知之甚少。
在中国农村地区,检查家庭经济状况高与低的精神分裂症患者在 14 年随访时结局的差异。
在成都市新津县的六个乡镇进行了一项前瞻性的 14 年随访研究。所有符合精神分裂症诊断标准的患者(n=510)均来自于一项针对 123572 名 15 岁及以上人群的流行病学调查,并于 1994 年至 2008 年进行随访。
1994 年家庭经济状况较低(<均值)的个体在 2008 年无家可归的比例明显较高(9.9%),存活率明显较低(63.8%),而家庭经济状况较高(⩾均值)的个体分别为 3.2%和 76.6%。2008 年,家庭经济状况较低的个体的婚姻和完全缓解率明显较低,阳性和阴性综合征量表(PANSS)的平均评分明显较高,而总体功能评估(GAF)的平均评分明显较低,而家庭经济状况较高的个体则明显较高。2008 年家庭经济状况较低的个体的预测因素包括基线家庭经济状况较低、家庭对患者的态度较差、年龄较小、首发年龄较大和病程较长。
家庭经济状况较低是农村社区精神分裂症患者长期预后不良的预测因素。在制定精神卫生政策和提供社区精神卫生服务时,应考虑个体的家庭经济状况。