Teo Pey Fang, Koh Eugene Boon Yau, Chong Seng Choi
Department of Psychiatry, Hospital Pakar Sultanah Fatimah, Johor, Malaysia.
Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
Malays J Med Sci. 2024 Dec;31(6):178-193. doi: 10.21315/mjms2024.31.6.14. Epub 2024 Dec 31.
A considerable number of schizophrenia patients still require long-term hospital care despite psychiatric deinstitutionalisation, especially in developing nations. Prolonged hospitalisation is associated with greater impairment in psychosocial functioning. This study aimed to determine the level of psychosocial functioning and its predictors among long-stay schizophrenia patients in a Malaysian mental institution.
This cross-sectional study included 138 patients selected through universal sampling. Data on socio-demographics, illness characteristics such as psychopathology and illness severity [measured using the Brief Psychiatric Rating Scale (BPRS)], and cognitive function [assessed using the Montreal Cognitive Assessment (MoCA)] were collected. The Personal and Social Performance (PSP) scale was used to evaluate psychosocial functioning. Pearson correlation coefficients and multiple linear regression analyses were applied to identify the correlates and predictors of psychosocial functioning.
This study found that 47.8% and 16.7% of the patients had moderate and severe cognitive impairments, respectively. The mean PSP score was 69.68 (standard deviation (SD) = 15.48). Female gender, previous unemployment and more severe cognitive impairments were significantly associated with poorer psychosocial functioning. Meanwhile, negative symptoms and age of onset were negatively correlated with psychosocial functioning. By contrast, the duration of illness was positively correlated with psychosocial functioning. The regression model indicated that being female (β = -7.32, < 0.001), previously unemployed (β = -3.67, < 0.047), having negative symptoms (β = -4.18, < 0.001), experiencing a longer illness duration (β = -0.60, = 0.004), and the presence of severe cognitive impairment (β = -9.80, < 0.001) significantly predicted poorer psychosocial functioning.
Long-stay schizophrenia patients experience substantial difficulties in psychosocial functioning. Factors such as gender, last employment status, negative symptoms, illness duration, and cognitive function affect psychosocial functioning.
尽管进行了精神科去机构化治疗，但仍有相当数量的精神分裂症患者需要长期住院治疗，尤其是在发展中国家。长期住院与心理社会功能的更大损害有关。本研究旨在确定马来西亚一家精神病院中长期住院的精神分裂症患者的心理社会功能水平及其预测因素。
本横断面研究通过整群抽样选取了138名患者。收集了社会人口统计学数据、疾病特征（如精神病理学和疾病严重程度[使用简明精神病评定量表（BPRS）测量]）以及认知功能[使用蒙特利尔认知评估量表（MoCA）评估]。使用个人和社会表现（PSP）量表来评估心理社会功能。采用Pearson相关系数和多元线性回归分析来确定心理社会功能的相关因素和预测因素。
本研究发现，分别有47.8%和16.7%的患者存在中度和重度认知障碍。PSP量表的平均得分为69.68（标准差（SD）=15.48）。女性、既往失业以及更严重的认知障碍与较差的心理社会功能显著相关。同时，阴性症状和发病年龄与心理社会功能呈负相关。相比之下，病程与心理社会功能呈正相关。回归模型表明，女性（β=-7.32，<0.001）、既往失业（β=-3.67，<0.047）、存在阴性症状（β=-4.18，<0.001）、病程较长（β=-0.60，=0.004）以及存在严重认知障碍（β=-9.80，<0.001）显著预测了较差的心理社会功能。
长期住院的精神分裂症患者在心理社会功能方面存在重大困难。性别、上次就业状况、阴性症状、病程和认知功能等因素会影响心理社会功能。
