Menditto A A, Beck N C, Stuve P, Fisher J A, Stacy M, Logue M B, Baldwin L J
Psychosocial Rehabilitation Services, Fulton State Hospital, Missouri 65251, USA.
Psychiatr Serv. 1996 Jan;47(1):46-51. doi: 10.1176/ps.47.1.46.
This study examined the combined effectiveness of clozapine and a comprehensive inpatient psychosocial rehabilitation program on the clinical functioning and aggressive behaviors of patients with chronic schizophrenia.
Two groups of 11 subjects each were selected from among patients being treated in the social learning program at Fulton (Mo.) State Hospital. Group 1 subjects were placed on clozapine at various times after the introduction of the program, while group 2 subjects remained on traditional antipsychotics throughout the study period. Group 1 and group 2 subjects were matched on clinical functioning as measured by the Time-Sample Behavioral Checklist (TSBC). For each subject, scores on six TSBC subscales were examined at five time points. Data were analyzed using repeated-measures multiple analysis of variance and univariate analyses of variance. Data on frequency of aggressive behaviors were aggregated into three six-month time periods and were analyzed using Wilcoxon signed-rank tests.
Both groups demonstrated significant improvement on several measures. However, the addition of clozapine resulted in accelerated improvement for group 1 subjects, especially in aggressive behaviors.
Comprehensive psychosocial treatment programming resulted in significant improvements in clinical functioning for many inpatients. Clozapine may enhance responsiveness to such programming for some patients.
本研究考察了氯氮平与全面的住院心理社会康复项目相结合对慢性精神分裂症患者临床功能和攻击行为的效果。
从密苏里州富尔顿市立医院接受社会学习项目治疗的患者中，每组选取11名受试者。第1组受试者在项目开展后的不同时间开始服用氯氮平，而第2组受试者在整个研究期间一直服用传统抗精神病药物。根据时间抽样行为清单（TSBC）测量的临床功能，对第1组和第2组受试者进行匹配。对每个受试者，在五个时间点检查TSBC六个分量表的得分。使用重复测量多元方差分析和单变量方差分析对数据进行分析。将攻击行为频率的数据汇总为三个六个月的时间段，并使用Wilcoxon符号秩检验进行分析。
两组在多项指标上均显示出显著改善。然而，添加氯氮平使第1组受试者的改善加速，尤其是在攻击行为方面。
全面的心理社会治疗方案使许多住院患者的临床功能得到显著改善。氯氮平可能会增强一些患者对该方案的反应性。
