缅因州和佛蒙特州对严重精神疾病的三十年研究。一、横断面结果的匹配比较。
The Maine and Vermont three-decade studies of serious mental illness. I. Matched comparison of cross-sectional outcome.
作者信息
DeSisto M J, Harding C M, McCormick R V, Ashikaga T, Brooks G W
机构信息
Bureau of Mental Health, State of Maine, Augusta, USA.
出版信息
Br J Psychiatry. 1995 Sep;167(3):331-8. doi: 10.1192/bjp.167.3.331.
BACKGROUND
This study compared long-term outcome of serious mental illness in two states using a matched design to assess psychiatric rehabilitation programmes; Vermont subjects participated in a model psychiatric rehabilitation programme, while the Maine group received more traditional care.
METHOD
Maine and Vermont subjects (n = 269) were matched by age, sex, diagnosis, and chronicity. Demographic, illness, and life history information were abstracted from hospital records by clinicians blind to outcome. DSM-III criteria were applied retrospectively. Outcome was assessed by clinicians blind to history.
RESULTS
Vermont subjects alive at follow-up (n = 180) were more productive (P < 0.0009), had fewer symptoms (P < 0.002), better community adjustment (P < 0.001) and global functioning (P < 0.001) than Maine subjects (n = 119).
CONCLUSIONS
Outcome differences may be due to Vermont's model programme and a policy of allowing an earlier opportunity for community life.
背景
本研究采用匹配设计比较了两个州严重精神疾病的长期治疗效果，以评估精神疾病康复项目；佛蒙特州的受试者参与了一个典型的精神疾病康复项目，而缅因州的受试者接受的是更为传统的治疗。
方法
缅因州和佛蒙特州的受试者（n = 269）按照年龄、性别、诊断结果和患病时长进行匹配。人口统计学、疾病和生活史信息由对结果不知情的临床医生从医院记录中提取。回顾性应用《精神疾病诊断与统计手册》第三版（DSM-III）标准。由对病史不知情的临床医生评估治疗结果。
结果
随访时仍存活的佛蒙特州受试者（n = 180）比缅因州受试者（n = 119）生产力更高（P < 0.0009）、症状更少（P < 0.002）、社区适应能力更好（P < 0.001）且整体功能更佳（P < 0.001）。
结论
治疗效果的差异可能归因于佛蒙特州的典型项目以及允许更早融入社区生活的政策。
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