Luo K, Yu D
Department of Social Psychiatry, Nanjing Neuropsychiatric Hospital, Jiangsu, PRC.
Br J Psychiatry Suppl. 1994 Aug(24):89-95.
This paper describes the development of community mental health services in Nanjing and reports on a retrospective study that compared the two-year outcome for 78 schizophrenic patients who attended four enterprise-based sheltered workshops (experimental group) with that of 78 schizophrenic patients who attended an out-patient clinic (control group). Despite having a longer course of illness and more prior hospital admissions than patients in the control group, at the end of the two years patients treated in enterprise-based sheltered workshops had significantly less psychosocial dysfunction (mean Social Dysfunction Screening Schedule score 3.4 (s.d. 0.2) v. 7.4 (s.d. 0.7), t = 49.2, d.f. 154, P < 0.001) and less severe psychiatric symptomatology (mean Brief Psychiatric Rating Scale score 33.1 (s.d. 2.7) v. 54.1 (s.d. 2.9), t = 47.0, d.f. 154, P < 0.001). Moreover, compared with the control group, over the two year period a smaller proportion of the experimental group experienced a clinical relapse (14.1% v. 38.5%, chi 2 = 5.10, d.f. 1, P < 0.05) or hospital readmission (7.7% v. 21.8%, chi 2 = 10.7, d.f. 1, P < 0.01). We conclude that the organisation of on-site sheltered workshops for mentally ill factory workers is an effective model for promoting community mental health that merits widespread application in China.
本文描述了南京社区心理健康服务的发展情况，并报告了一项回顾性研究，该研究比较了78名在四个企业庇护工场接受治疗的精神分裂症患者（实验组）与78名在门诊接受治疗的精神分裂症患者（对照组）的两年治疗结果。尽管实验组患者的病程比对照组患者更长，且之前住院次数更多，但在两年结束时，在企业庇护工场接受治疗的患者的社会心理功能障碍明显更少（社会功能障碍筛查量表平均得分3.4（标准差0.2）对7.4（标准差0.7），t = 49.2，自由度154，P < 0.001），精神症状也不那么严重（简明精神病评定量表平均得分33.1（标准差2.7）对54.1（标准差2.9），t = 47.0，自由度154，P < 0.001）。此外，与对照组相比，在两年期间，实验组经历临床复发的比例较小（14.1%对38.5%，卡方 = 5.10，自由度1，P < 0.05）或再次住院的比例较小（7.7%对21.8%，卡方 = 10.7，自由度1，P < 0.01）。我们得出结论，为患有精神疾病的工厂工人组织现场庇护工场是促进社区心理健康的一种有效模式，值得在中国广泛应用。
