个案管理对伴有精神病性症状的抑郁症患者社会功能的影响

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Abstract Objective To explore the influence of case management on social function of psychotic major depression patients. Methods A total of 87 cases of depression psychotic major patients who were treated in Nanhui Mental Health Center, Pudong New Area, Shanghai from January 2013 to October 2014 were selected as the study subjects, and they were divided into study group (43 cases) and control group (44 cases) according to the random block group method. The study group implemented the case management program, and the control group carried out the general outpatient follow-up program. At the time of enrollment, three, six, and twelve months after treatment, Hamilton depression scale-17 items (HAMD-17), brief psychiatric rating scale (BPRS), and family assessment device (FAD) and insight and treatment attitude questionnaire (ITAQ) were used for evaluation and comparison. Results A total of 79 cases (41 in the study group and 38 in the control group) were finally completed. The differences in BPRS and HAMD scores among groups, time points and interaction were statistically significant (all P ＜ 0.05). BPRS and HAMD scores of the two groups at three, six and twelve months of treatment in the two groups were all lower than those at the time of enrollment, those at six and twelve months of treatment were less than three months of treatment, and those at twelve months of treatment were less than six months of treatment, and the differences were statistically significant (all P ＜ 0.05). The BPRS scores of the study group at three, six and twelve months of treatment were lower those of the control group, and the HAMD scores of the study group at six and twelve months of treatment were lower those of the control group, with statistically significant differences (all P ＜ 0.05). The differences in FAD scores among groups and time points were statistically significant (P ＜ 0.05), but the interaction difference was not statistically significant (P ＞ 0.05). The FAD scores of the two groups at three, six and twelve months of treatment in both groups were lower than those at enrollment, and those at six and twelve months of treatment were less than three months of treatment, and those at twelve months of treatment were less than six months of treatment, and the differences were statistically significant (all P ＜ 0.05). The FAD scores of the study group were lower than those of the control group at six and twelve months of treatment, and the differences were statistically significant (all P ＜ 0.05). There were statistically significant differences in ITAQ score at time point and interaction (all P ＜ 0.05), while there were no statistically significant differences between groups (P ＞ 0.05). ITAQ scores of the two groups at three, six and twelve months of treatment were all higher than those at the time of enrollment, and those at six and twelve months of treatment were higher than those at three months of treatment, and those at twelve months of treatment were higher than those at six months of treatment, with statistically significant differences (all P ＜ 0.05). There were no significant differences in ITAQ scores between the two groups at each time point (P ＞ 0.05). The study group was significantly better than the control group in terms of medication compliance, recurrence and re-employment within twelve months of treatment, with statistically significant differences (all P ＜ 0.05). Conclusion Compared with general outpatient follow-up, case management can improve patients′ medication compliance, thus effectively relieve patients′ depressive symptoms and accompanying psychiatric symptoms, improve social function, and increase employment rate.

Key words： Depression Psychotic symptoms Case management Social function

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	YAO Lin GU Chunhong

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YAO Lin GU Chunhong. Influence of case management on social function of psychotic major depression patients[J]. 中国医药导报, 2020, 17(28): 100-104.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I28/100

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