Centro de Tratamiento Integral, Área de Gestión Clínica de Salud Mental V, Hospital Universitario de Cabueñes, Gijón, Servicio de Salud del Principado de Asturias SESPA, Gijón, Spain; Departamento de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain.
Centro de Tratamiento Integral, Área de Gestión Clínica de Salud Mental V, Hospital Universitario de Cabueñes, Gijón, Servicio de Salud del Principado de Asturias SESPA, Gijón, Spain.
Rev Psiquiatr Salud Ment (Engl Ed). 2022 Jan-Mar;15(1):47-53. doi: 10.1016/j.rpsmen.2022.01.002. Epub 2022 Jan 31.
To determine the psychiatric hospitalizations of patients with severe schizophrenia before (standard treatment in mental health centres) and during treatment in a comprehensive, community-based, case-managed programme, as well as the role played by antipsychotic medication (oral or long-acting injectable).
Observational, mirror image study of ten years of follow-up and ten retrospectives ('pre-treatment': standard), of patients with severe schizophrenia in a community-based programme, with pharmacological and psychosocial integrated treatment and intensive case management (N = 344). Reasons for discharge from the programme and psychiatric hospital admissions (and whether they were involuntary) were recorded ten years before and during treatment, as well as the antipsychotic medication prescribed.
The retention achieved in the programme was high: after 10 years only 12.2% of the patients were voluntary discharges vs 84.3% on previous standard treatment. The number of patients with hospital admissions, and number of admissions due to relapses decreased drastically after entering the programme (P < .0001), as well the involuntary admissions (P < .001). Being on long-acting injectable antipsychotic medication was related with these results (P < .0001).
Treatment of patients with severe schizophrenia in a comprehensive, community-based and case-managed programme achieved high retention rates, and was effective in drastically reducing psychiatric hospitalizations compared to the previous standard treatment in mental health units. Undergoing treatment with long-acting injectable antipsychotics was clearly linked to these outcomes.
确定严重精神分裂症患者在（精神卫生中心的标准治疗）之前和综合、基于社区、个案管理计划治疗期间的精神病住院情况，以及抗精神病药物（口服或长效注射）的作用。
对十年随访和十项回顾性研究（“治疗前”：标准）的观察性镜像研究，对基于社区的计划中的严重精神分裂症患者进行药物和心理社会综合治疗及强化个案管理（N=344）。记录十年前和治疗期间的出院原因和精神病住院情况（是否为非自愿），以及开处的抗精神病药物。
该计划的保留率很高：十年后，只有 12.2%的患者是自愿出院，而之前的标准治疗为 84.3%。进入该计划后，住院人数和因复发而住院的人数急剧减少（P<.0001），非自愿住院人数也减少（P<.001）。使用长效注射抗精神病药物与这些结果有关（P<.0001）。
在综合、基于社区和个案管理的计划中治疗严重精神分裂症患者，保留率高，与精神卫生单位的先前标准治疗相比，精神病住院治疗效果显著降低。使用长效注射抗精神病药物治疗与这些结果明显相关。
