Carpiniello B, Salis P, Pariante C M, Carta M G, Rudas N
Istituto di Clinica Psichiatrica, Università degli Studi, Cagliari.
Minerva Psichiatr. 1995 Mar;36(1):1-10.
The aim of the present study is to investigate the possible clinical and symptomatological determinants of social outcome in schizophrenic patients.
40 schizophrenic patients (DSMIII-R), 21 males and 19 females, mean age 4 +/- 5 years, have been evaluated in the present retrospective study. All of them had first undergone psychiatric hospitalization between 1978 and 1981. The following data have been collected: socio-anagraphic features and course of the illness (AMDP), contacts with community health centre and pharmacological compliance. Social disability has been investigated by means of a semi-structured interview developed from the "Disability Assessment Schedule" named "Accertamento Disabilità e Carico Familiare" (ADC), which has been administered to the main carer, usually a cohabitant relative. Presence and level of social support have also been evaluated. One Way Analysis of Variance (ANOVA), "t" test with Bonferroni correction and Pearson Correlation test have been used for data analysis.
Patients with less severe social disability (lower scores at ADC) were mainly those with recurrent course of illness without residual symptoms or remitted ones (p = 0.0001), better pharmacological compliance (p = 0.004), more frequent and regular contacts with community health centres (p = 0.0001) and better social support (p = 0.01). On the contrary, score at ADC resulted positively correlated with number of hospitalizations (r = 0.57, p = 0.01), number of compulsory admission (r = 0.32, p = 0.01) and length of illness (r = 0.40, p = 0.01).
Although in our study the influence of severity of illness on social disability has been confirmed, suggestive evidence about importance of other factors, such as compliance or social support, may be drawn.
本研究旨在调查精神分裂症患者社会结局可能的临床和症状学决定因素。
在本回顾性研究中，对40例精神分裂症患者（DSMIII-R）进行了评估，其中男性21例，女性19例，平均年龄4±5岁。他们均于1978年至1981年间首次接受精神病住院治疗。收集了以下数据：社会人口学特征和病程（AMDP）、与社区卫生中心的接触情况和药物依从性。通过一项基于“残疾评估量表”编制的名为“残疾与家庭负担评估”（ADC）的半结构化访谈对社会残疾情况进行了调查，该访谈由主要照顾者（通常是同居亲属）完成。还评估了社会支持的存在情况和水平。数据分析采用单因素方差分析（ANOVA）、经Bonferroni校正的“t”检验和Pearson相关检验。
社会残疾程度较轻（ADC得分较低）的患者主要是那些病程呈复发型且无残留症状或已缓解的患者（p = 0.0001）、药物依从性较好的患者（p = 0.004）、与社区卫生中心接触更频繁且规律的患者（p = 0.0001）以及社会支持较好的患者（p = 0.01）。相反，ADC得分与住院次数（r = 0.57，p = 0.01）、强制住院次数（r = 0.32，p = 0.01）和病程长度（r = 0.40，p = 0.01）呈正相关。
尽管在我们的研究中已证实疾病严重程度对社会残疾有影响，但也可以得出关于其他因素（如依从性或社会支持）重要性的提示性证据。
