Klinkenberg W D, Calsyn R J
Missouri Institute of Mental Health, St. Louis, Missouri 63139, USA.
Psychiatr Serv. 1996 May;47(5):487-96. doi: 10.1176/ps.47.5.487.
This paper provides a comprehensive review of research predicting receipt of aftercare and recidivism (rehospitalization) among individuals with severe and persistent mental illness.
English-language studies were identified by searching PsycLIT from January 1974, the year of a previous comprehensive review of the literature on recidivism, to March 1994. A heuristic model was used to classify predictor variables into three categories: client vulnerability, community support, and system responsiveness.
In general, variables related to system responsiveness were more consistent predictors of receipt of aftercare than variables related to either client vulnerability or community support. Community support variables were more consistent predictors of recidivism than variables in any of the other categories. Assertive community treatment and receipt of aftercare-both system responsiveness variables-were also associated with lower rates of rehospitalization.
Conclusions based on past research should be regarded as tentative, because of several methodological and theoretical weaknesses. Multivariate statistics have rarely been used, many of the studies are based on nonrepresentative samples, and interactions between client-level variables and system responsiveness variables have rarely been studied. Much of the research has relied on archival data, and choice of variables has thus often been guided more by the data available than by theory.
本文全面综述了关于预测重症及持续性精神疾病患者后续护理接受情况和再入院率（复发）的研究。
通过检索1974年1月（此前对再入院率文献进行全面综述的年份）至1994年3月的心理学文摘数据库（PsycLIT），确定了英文研究。采用启发式模型将预测变量分为三类：患者易损性、社区支持和系统响应性。
总体而言，与系统响应性相关的变量比与患者易损性或社区支持相关的变量更能持续预测后续护理的接受情况。社区支持变量比其他任何类别中的变量更能持续预测再入院率。积极社区治疗和后续护理接受情况（均为系统响应性变量）也与较低的再入院率相关。
由于存在若干方法和理论上的弱点，基于过去研究得出的结论应视为初步结论。多变量统计很少被使用，许多研究基于非代表性样本，患者层面变量与系统响应性变量之间的相互作用很少被研究。许多研究依赖档案数据，因此变量的选择往往更多地受现有数据而非理论的指导。
