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妄想性精神病的病程及转归

Social course and outcome of delusional psychosis.

作者信息

Jørgensen P

出版信息

Acta Psychiatr Scand. 1987 Jun;75(6):629-34. doi: 10.1111/j.1600-0447.1987.tb02847.x.

Abstract

The purpose of the study was to examine first-admitted patients with delusional psychosis regarding social background, course and outcome. The study was handicapped by the lack of data of social variables as regards population in the catchment area, so comparisons were made with the population in the County and in the Nation. The index population comprised 88 patients. Social variables such as civil state and cohabitation are presented. At admission one-third had been employed continuously during the past year, while one-fourth had had no useful work at all. Significantly more patients were recruited from the lowest social group. Significantly more patients had inadequate social support, and two-thirds met friends less than once a week on an average. Only one-fourth of the patients seemed socially well adjusted and economically self-supporting. At follow-up 2 years later the distribution of the patients as regards useful work, social support, social contacts and social adjustment has significantly changed with more patients now with less useful work and social support, fewer social contacts and increased social maladjustment. The difficulty of interpretation of the findings is stressed but it is concluded that the present psychiatric treatment including social intervention is insufficient to prevent this social downlift mobility during a 2-year observation period as regards patients with delusional psychosis. Further study will search for social predictors of course and outcome.

摘要

该研究的目的是调查首次收治的妄想性精神病患者的社会背景、病程及预后。由于缺乏有关集水区人口社会变量的数据,该研究受到了阻碍,因此与该县及全国的人口进行了比较。该指标人群包括88名患者。呈现了婚姻状况和同居等社会变量。入院时,三分之一的患者在过去一年中持续就业,而四分之一的患者完全没有从事过有意义的工作。从最低社会阶层招募的患者明显更多。社会支持不足的患者明显更多,三分之二的患者平均每周与朋友见面少于一次。只有四分之一的患者似乎在社会上适应良好且经济上能够自给自足。两年后的随访显示,患者在有意义的工作、社会支持、社会交往和社会适应方面的分布发生了显著变化,现在有更多患者从事的有意义工作和社会支持减少,社会交往减少,社会适应不良增加。强调了对研究结果进行解释的困难,但得出的结论是,就妄想性精神病患者而言,目前包括社会干预在内的精神科治疗不足以在两年的观察期内防止这种社会地位下降的流动。进一步的研究将寻找病程和预后的社会预测因素。

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