临床误诊误治2024,Vol.37Issue(7) :54-59.DOI:10.3969/j.issn.1002-3429.2024.07.011

精神分裂症患者精神残疾状况、影响因素及对生活质量的影响

Mental Disability Status,Influencing Factors and Their Impact on Quality of Life in Patients with Schizophrenia

邢字航 甄晓红 李雅彤 任利民 孙岩
临床误诊误治2024,Vol.37Issue(7) :54-59.DOI:10.3969/j.issn.1002-3429.2024.07.011

精神分裂症患者精神残疾状况、影响因素及对生活质量的影响

Mental Disability Status,Influencing Factors and Their Impact on Quality of Life in Patients with Schizophrenia

邢字航 1甄晓红 1李雅彤 2任利民 1孙岩3
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作者信息

  • 1. 050000 石家庄,石家庄市第八医院精三科
  • 2. 050000 石家庄,石家庄市人民医院精神科
  • 3. 050000 石家庄,石家庄市中医院公共卫生科
  • 折叠

摘要

目的 探究精神分裂症患者精神残疾状况、影响因素及其对生活质量的影响.方法 选取 2020 年 12月—2022 年12 月收治的250 例精神分裂症,根据世界卫生组织残疾评定量表Ⅱ(WHO DAS Ⅱ)评分分为精神残疾组210 例和非精神残疾组40 例.比较2 组临床资料,入院 1 个月后的简明精神病评定量表(BPRS)和患者积极度量表(PAM)评分;采用世界卫生组织生活质量评定量表简表(WHOQOL BREF)评分比较2 组入院1 个月后的生活质量;采用受试者工作特征(ROC)曲线分析相关指标对精神分裂症患者精神残疾发生的诊断价值;采用多因素Logistic回归分析影响精神分裂症患者发生精神残疾的危险因素;采用Pearson相关性分析相关评分与WHO DAS Ⅱ评分的关系.结果 精神残疾组较非精神残疾组病程更长,复发次数更多,家庭氛围不和谐及偏执型人数占比更大,已婚人数占比更少,受教育年限更短,月收入更低(P<0.05,P<0.01).精神残疾组BPRS评分高于非精神残疾组,WHOQOL BREF和PAM评分低于非精神残疾组(P<0.01).ROC曲线分析结果表明,病程、复发次数、受教育年限、月收入、BPRS评分、WHOQOL BREF评分和PAM评分对精神分裂症患者精神残疾的发生具有良好的诊断价值(P<0.01).多因素Logistic回归分析显示,复发次数多、家庭氛围不和谐、BPRS评分过高、WHOQOL BREF评分过低是影响精神分裂症患者发生精神残疾的独立危险因素(P<0.01).Pearson相关性分析显示,BPRS评分与WHO DAS Ⅱ评分呈正相关性(r=0.899,P<0.001),WHOQOL BREF评分与WHO DAS Ⅱ评分呈负相关性(r=-0.886,P<0.001).结论 复发次数多、家庭氛围不和谐、BPRS评分高、WHOQOL BREF评分低均能促使精神分裂症患者发生精神残疾,且患者精神残疾状况及影响因素对其生活质量影响显著.

Abstract

Objective To explore mental disability status,influencing factors and their impact on quality of life in patients with schizophrenia.Methods In total,250 patients with schizophrenia were selected.According to scores of World Health Organization Disability Assessment Schedule Ⅱ(WHO DAS Ⅱ),patients were divided into mental disability group(n=210)and non-disability group(n=40).The clinical data,scores of the Brief Psychiatric Rating Scale(BPRS)and Pa-tient Activation Measure(PAM)at admission were compared between the two groups.The quality of life at 1 month after ad-mission in the two groups was compared by World Health Organization Quality of Life-BREF(WHOQOL BREF).Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of relevant indicators for the occurrence of men-tal disability in patients with schizophrenia.The risk factors of mental disability were analyzed by Logistic regression analysis.The relationship between the related scores and WHO DAS Ⅱ score was analyzed by Pearson correlation analysis.Results Compared with non-disability group,course of the disease was longer,recurrence frequency and proportions of cases with fami-ly disharmony and intolerance style were higher,proportion of married cases was lower,the years of education was shorter and monthly income was lower in mental disability group(P<0.05,P<0.01).BPRS score in mental disability group was higher than that in non-disability group,while WHOQOL BREF and PAM scores were lower than those in non-disability group(P<0.01).The results of ROC curve analysis indicated that the course of disease,recurrence frequency,years of education,monthly income,BPRS score,WHOQOL BREF score,and PAM score had good diagnostic value for the occurrence of mental disability in patients with schizophrenia(P<0.01).The results of multivariate Logistic regression analysis showed that higher frequency of recurrence,family disharmony,higher BPRS score and lower WHOQOL BREF score were all independent risk factors of mental disability in patients with schizophrenia(P<0.01).Pearson correlation analysis showed that BPRS score was positively correlated with WHO DASⅡscore(r=0.899,P<0.001),while WHOQOL BREF score was negatively cor-related with WHO DASⅡscore(r=-0.886,P<0.001).Conclusion High frequency of recurrence,family disharmony,high BPRS score and lower WHOQOL BREF score will all cause mental disability in patients with schizophrenia,and the men-tal disability status and influencing factors of patients have a significant impact on their quality of life.

关键词

精神分裂症/精神残疾/影响因素分析/生活质量/残疾评定量表Ⅱ/简明精神病评定量表/世界卫生组织生活质量评定量表简表/相关性

Key words

Schizophrenia/Mental disability/Analysis of influencing factors/Quality of life/Disability rating scaleⅡ/Brief psychiatric rating scale/World Health Organization Quality of Life-BREF/Correlation

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基金项目

河北省卫生健康委医学科学研究项目(20221653)

出版年

2024
临床误诊误治
解放军白求恩国际和平医院

临床误诊误治

CSTPCD
影响因子:0.914
ISSN:1002-3429
参考文献量22
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