Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, ROC.
School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan, ROC.
Eur Arch Psychiatry Clin Neurosci. 2020 Apr;270(3):301-310. doi: 10.1007/s00406-019-01000-5. Epub 2019 Apr 22.
Little is known about the changes of people with schizophrenia disability in Taiwan who receive routine treatments under the current mental healthcare system. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess and track changes in the degree of disability in people with schizophrenia before and after 4 years of follow-up. Data on 4497 people with schizophrenia were acquired from the Taiwan Data Bank of Persons with Disability. The WHODAS 2.0 was used for disability assessment, and the chi-square test, logistic regression and generalised estimating equations were adopted for statistical analysis. People with schizophrenia exhibited improvement in cognition, mobility and participation among the six domains as well as in the overall score. The degree of disability in all domains remained mild to moderate among people aged 18-64 years; the degree of disability in cognition declined from moderate to severe among patients aged ≥65 years. The degree of disability in all domains remained mild to moderate among people with mild to moderate impairment; among those with severe impairment, the degree of disability in the domains of cognition and life activities declined from moderate to severe and the degree of disability in the domain of mobility declined from mild to moderate. Community-dwelling patients exhibited less degree of disability in all domains than their institutionalised peers. Early detection and treatment and an emphasis on communication and social problem-solving skills in rehabilitation programmes are recommended for people with schizophrenia.
关于在当前精神卫生保健系统下接受常规治疗的台湾精神分裂症残疾患者的变化,知之甚少。本研究使用世界卫生组织残疾评估表 2.0(WHODAS 2.0)来评估和跟踪 4 年随访前后精神分裂症患者残疾程度的变化。从台湾残疾人数据库中获取了 4497 名精神分裂症患者的数据。使用 WHODAS 2.0 进行残疾评估,采用卡方检验、逻辑回归和广义估计方程进行统计分析。结果显示,精神分裂症患者在六个领域的认知、行动和参与以及总分方面都有所改善。18-64 岁人群所有领域的残疾程度仍为轻度至中度;≥65 岁患者的认知残疾程度从中度降至重度。轻度至中度损伤患者所有领域的残疾程度仍为轻度至中度;严重损伤患者认知和生活活动领域的残疾程度从中度降至重度,行动领域的残疾程度从轻度降至中度。与住院患者相比,社区居住的患者在所有领域的残疾程度都较低。建议对精神分裂症患者进行早期发现和治疗,并在康复计划中强调沟通和社会问题解决技能。