中国精神分裂症患者不同家庭干预措施效果比较的meta分析

doi:10.3785/j.issn.1008-9292.2015.11.15

浙江大学学报（医学版）

2015, Vol. 44

Issue (6): 689-702 DOI: 10.3785/j.issn.1008-9292.2015.11.15

Meta 分析

中国精神分裂症患者不同家庭干预措施效果比较的meta分析

陈楠¹, 安景欢¹, 杨珉^1,2, 刘元元¹

1. 四川大学华西公共卫生学院流行病与卫生统计学系, 四川成都 610041;
2. 西部农村卫生发展研究中心, 四川成都 610041

Efficacy of family intervention in management of schizophrenic patients in China: a meta-analysis

CHEN Nan¹, AN Jing-huan¹, YANG Min^1,2, LIU Yuan-yuan¹

1. Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, China;
2. West China Research Center for Rural Health Development, Chengdu 610041, China

全文: PDF(1399 KB)

摘要:

目的:对中国精神分裂症患者采取家庭干预的研究文献进行综合回顾和系统评价,比较不同条件下家庭干预效果的差异。方法:在中国知网、维普、万方、中国生物医学文献数据库四大中文数据库及OVID Medline、Science Direct、Web of Science、EBSCO四大英文数据库中,检索各数据库建库至2015年1月为止使用社会功能缺陷筛选量表(SDSS)、简明精神病(科)量表(BPRS)、阳性与阴性症状量表(PANSS)研究中国精神分裂症患者家庭干预效果的文献,以标准化加权均数差(SMD)作为效应量,采用meta分析比较不同干预时间、不同干预类型、对不同病程和不同严重程度的精神分裂症患者的家庭干预效果差异。结果:共纳入57篇符合标准的文献。SDSS、PANSS分析结果显示:①干预时间越长干预效果越好(P<0.0001、P=0.0025);②单独家庭干预比多个家庭合并单独家庭干预的效果更明显(P<0.0001、 P=0.0131);③干预对于病情较重患者效果较好(P<0.0001、P=0.0280)。SDSS量表还显示家庭干预对于病程短的患者效果更好(P<0.0001)。结论:家庭干预更适合病程较短的精神分裂症患者,干预应实施较长时间;单独家庭干预更有利于患者阴性症状的改善和社会功能的康复,且对于病情较轻患者的阴性症状改善效果更好。

关键词 ：家庭, 精神分裂症/预防和控制, 评价研究, 干预性研究, Meta分析(主题)

Abstract：

Objective: To assess the efficacy of family intervention in management of schizophrenic patients in China. Methods: Chinese databases CNKI, VIP, WANFANG, CBM and English databases OVID Medline, Science Direct, Web of science, EBSCO were searched systematically from inception to January 2015. Quantitative and empirical studies on the outcomes of social disability screening scale (SDSS), brief psychiatric rating scale (BPRS) and positive and negative syndrome scale (PANSS) of family intervention for Chinese schizophrenic patients were selected. The effect size was derived from the standardized mean difference (SMD), and meta-analysis was conducted to compare effects of family intervention by intervention types, time of intervention, durations of illness and severity of schizophrenia.Results: The study included 57 articles that met inclusion criteria. SDSS and PANSS scores revealed that the effect was positively associated with the length of intervention time (P<0.0001, P=0.0025); the effect of single family intervention was better than that of combined single and multiple family intervention (P<0.0001, P=0.0131); the effect was better for patients with severe conditions than those with less severe conditions (P<0.0001, P=0.0280). The SDSS showed that the effect was better for patients with shorter disease duration (P<0.0001). Conclusion: The results suggest that the long single family intervention would benefit to schizophrenic patients, particularly for severe patients with short disease duration.

Key words： Family Schizophrenia/prevention & control Evaluation studies Intervention studies Meta-analysis as topic

收稿日期: 2015-04-30

CLC:

R749.3

基金资助:

美国纽约中华医学基金会(CMB)四川大学合作中心项目(12-106)

通讯作者: 刘元元(1979-),女,博士,讲师,主要从事风险评估及预测研究;E-mail:y_multi@126.com;http://orcid.org/0000-0002-1683-5809 E-mail: y_multi@126.com

作者简介: 陈楠(1989-),女,硕士研究生,主要从事卫生政策和系统评价方法研究;E-mail:chennan910@sina.com;http://orcid.org/0000-0002-4145-6456

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引用本文:

陈楠等. 中国精神分裂症患者不同家庭干预措施效果比较的meta分析[J]. 浙江大学学报（医学版）, 2015, 44(6): 689-702.
CHEN Nan, AN Jing-huan, YANG Min, LIU Yuan-yuan. Efficacy of family intervention in management of schizophrenic patients in China: a meta-analysis. Journal of ZheJiang University(Medical Science), 2015, 44(6): 689-702.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2015.11.15 或 http://www.zjujournals.com/xueshu/med/CN/Y2015/V44/I6/689

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