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对经历单独隔离或与约束相结合隔离的急性精神分裂症患者的心理评估。

Psychological assessment of acute schizophrenia patients who experienced seclusion either alone or in combination with restraint.

作者信息

Eguchi Rika, Onozuka Daisuke, Ikeda Kouji, Kuroda Kenji, Ieiri Ichiro, Hagihara Akihito

机构信息

1 Department of Health Services Management and Policy, Graduate School of Medicine, Kyushu University, Fukuoka, Japan.

2 Department of Clinical Pharmacokinetics, Graduate School of Pharmaceutical Science, Kyushu University, Fukuoka, Japan.

出版信息

Int J Psychiatry Med. 2018 May;53(3):171-188. doi: 10.1177/0091217417749788. Epub 2017 Dec 27.

Abstract

Objective Numerous studies on the effects of seclusion and/or restraint in acute psychiatric treatment have reported both positive and negative effects. However, no studies to date have evaluated the effects of seclusion and/or restraint on schizophrenia patients using a rating scale. Thus, to examine the effects of seclusion and/or restraint on schizophrenia patients, we used the Brief Psychiatric Rating Scale and assessed the psychological condition of patients. Methods Factor analysis was conducted to create subscales of Brief Psychiatric Rating Scale, and psychiatric changes were assessed with respect to each subscale using multiple logistic regression analyses. Analyses were performed on three groups (i.e. entire, higher functioning, and lower functioning groups) involving a total of 1559 schizophrenia patients aged 18 to 65 years. Results In the entire and lower functioning groups, seclusion was a significant predictor of improvements related to the "hostility/suspiciousness" subscale. Seclusion combined with restraint was associated with improvements related to the "psychosis/thinking disorder" subscale. In the higher functioning group, there were no significant predictors. Conclusions It is implied that seclusion and/or restraint is related to improved psychiatric symptoms only among patients whose functioning is impaired. To verify the present findings, further studies involving multiple sites and additional psychiatric measures are necessary.

摘要

目的 众多关于急性精神病治疗中隔离和/或约束效果的研究报告了其积极和消极影响。然而,迄今为止尚无研究使用评定量表评估隔离和/或约束对精神分裂症患者的影响。因此,为了研究隔离和/或约束对精神分裂症患者的影响,我们使用简明精神病评定量表并评估了患者的心理状况。方法 进行因子分析以创建简明精神病评定量表的子量表,并使用多元逻辑回归分析评估每个子量表的精神状态变化。对三组(即全部、功能较高和功能较低组)共1559名年龄在18至65岁的精神分裂症患者进行了分析。结果 在全部组和功能较低组中,隔离是与“敌意/猜疑”子量表相关改善的显著预测因素。隔离与约束相结合与“精神病性/思维障碍”子量表相关的改善有关。在功能较高组中,没有显著的预测因素。结论 这意味着隔离和/或约束仅与功能受损患者的精神症状改善有关。为验证当前研究结果,有必要开展涉及多个地点和更多精神科测量方法的进一步研究。

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