Tyrer P, Merson S, Onyett S, Johnson T
Academic Unit of Psychiatry, St Charles Hospital (St Mary's Hospital Medical School), London.
Psychol Med. 1994 Aug;24(3):731-40. doi: 10.1017/s0033291700027884.
One hundred psychiatric emergencies presenting to an inner London teaching hospital had formal assessments of psychopathology, personality disorder (using both ICD-10 and the Personality Assessment Schedule), social networks and social functioning before being randomly assigned to a multidisciplinary community-based team (Early Intervention Service (N = 48) or conventional hospital-based psychiatric services (N = 52) and treated for a period of 12 weeks. The ICD-10 classification yielded a higher proportion (50%) of personality disordered patients than the Personality Assessment Schedule (34%) and those from ethnic minorities (mainly Afro-Caribbean) and upper social classes had a lower incidence of personality disorder. Social networks were smaller in personality disordered patients and there were fewer attachment figures. Improvement in social function, and to a lesser extent with depressive symptomatology, was better in patients with no differences were found between the numbers and duration of social contacts in the two services and it is concluded that the better outcome in the community-treated patients was independent of changes in social networks.
伦敦市中心一家教学医院接收的100例精神科急诊患者，在被随机分配到多学科社区团队（早期干预服务组，N = 48）或传统的医院精神科服务组（N = 52）并接受为期12周的治疗之前，均接受了精神病理学、人格障碍（采用国际疾病分类第10版（ICD - 10）和人格评估量表）、社会网络及社会功能的正式评估。ICD - 10分类得出的人格障碍患者比例（50%）高于人格评估量表得出的比例（34%），且来自少数民族（主要是非洲 - 加勒比裔）和社会上层阶级的患者人格障碍发病率较低。人格障碍患者的社会网络较小，依恋对象也较少。在社会功能改善方面，以及在较小程度上的抑郁症状改善方面，无人格障碍患者更好。两种服务的社会接触数量和时长没有差异，研究得出结论，社区治疗患者的较好结局与社会网络的变化无关。
