Schooler N R, Levine J, Severe J B, Brauzer B, DiMascio A, Klerman G L, Tuason V B
Arch Gen Psychiatry. 1980 Jan;37(1):16-24. doi: 10.1001/archpsyc.1980.01780140018002.
We tested the role of guaranteed delivery of medication in the prevention of relapse and the enhancement of adjustment in the community in patients with schizophrenia. Two hundred and ninety newly hospitalized patients at four hospitals were randomly assigned to groups receiving either long-acting injectable fluphenazine decanoate or short-acting oral fluphenazine hydrochloride. After discharge and stabilization, patients were treated in the community for up to one year. By the end of the year, 28% of all the patients had relapsed. Contrary to hypothesis, differences between the two treatment groups in relapse percentages were not significant. Furthermore, there were no differences between the treatment groups as to development of affective symptomatology or social adjustment. Patients who rated themselves as having more symptom distress at the start of the community-maintenance phase of the study relapsed much earlier while receiving fluphenazine decanoate rather than fluphenazine hydrochloride. The results suggest that compliance is not an important determinant of relapse among newly discharged schizophrenic patients.
我们测试了药物保证递送在预防精神分裂症患者复发及促进其社区适应方面的作用。四家医院的290名新住院患者被随机分为两组，分别接受长效注射用氟奋乃静癸酸酯或短效口服盐酸氟奋乃静治疗。出院并病情稳定后，患者在社区接受长达一年的治疗。到年底时，所有患者中有28%复发。与假设相反，两个治疗组在复发率上的差异并不显著。此外，在情感症状发展或社会适应方面，治疗组之间也没有差异。在研究的社区维持阶段开始时自我评定症状困扰较多的患者，在接受氟奋乃静癸酸酯而非盐酸氟奋乃静治疗时复发要早得多。结果表明，依从性并非新出院精神分裂症患者复发的重要决定因素。
