Estudio en imagen en espejo (10 años de seguimiento y 10 de pretratamiento estándar) de ingresos hospitalarios de personas con esquizofrenia grave en un programa comunitario con gestión de casos

IF 5.2 3区 医学 Q1 PSYCHIATRY
Silvia Díaz-Fernández , Danny Francisco Frías-Ortiz , Juan José Fernández-Miranda
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引用次数: 9

Abstract

Objectives

To determine the psychiatric hospitalizations of patients with severe schizophrenia before (standard treatment in mental health centres) and during treatment in a comprehensive, community-based, case- managed programme, as well as the role played by antipsychotic medication (oral or long-acting injectable).

Method

Observational, mirror image study of ten years of follow-up and ten retrospectives (‘pre-treatment’: standard), of patients with severe schizophrenia in a community-based programme, with pharmacological and psychosocial integrated treatment and intensive case management (n = 344). Reasons for discharge from the programme and psychiatric hospital admissions (and whether they were involuntary) were recorded ten years before and during treatment, as well as the antipsychotic medication prescribed.

Results

The retention achieved in the programme was high: after 10 years only 12.2% of the patients were voluntary discharges vs 84.3% on previous standard treatment. The number of patients with hospital admissions, and number of admissions due to relapses decreased drastically after entering the programme (p < 0,0001), as well the involuntary admissions (p < 0,001). Being on long-acting injectable antipsychotic medication was related with these results (p < 0,0001).

Conclusions

Treatment of patients with severe schizophrenia in a comprehensive, community-based and case-managed programme achieved high retention rates, and was effective in drastically reducing psychiatric hospitalizations compared to the previous standard treatment in mental health units. Undergoing treatment with long-acting injectable antipsychotics was clearly linked to these outcomes.

社区病例管理项目中严重精神分裂症患者住院的镜像研究(10年随访和10年标准治疗前)
目的了解重度精神分裂症患者在精神卫生中心标准治疗前和在综合、社区、病例管理方案治疗期间的精神住院情况,以及抗精神病药物(口服或长效注射)的作用。方法:观察性镜像研究,10年随访和10年回顾性研究(“治疗前”:标准),在一个以社区为基础的方案中,采用药物和社会心理综合治疗和强化病例管理(n = 344)。在治疗前和治疗期间,记录了出院的原因和精神病医院的入院情况(以及是否非自愿),并记录了处方的抗精神病药物。结果该方案的保留率很高:10年后,只有12.2%的患者自愿出院,而以前的标准治疗为84.3%。参加该方案后,入院的病人人数和因复发而入院的人数急剧减少(p <2001),以及非自愿入院(p <0001)。服用长效注射抗精神病药物与这些结果有关(p <0, 0001)。结论:以社区为基础、病例管理的综合治疗方案对严重精神分裂症患者的治疗取得了很高的保留率,与之前在精神卫生单位的标准治疗相比,有效地大大减少了精神病学住院率。接受长效注射抗精神病药物治疗显然与这些结果有关。
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来源期刊
自引率
3.30%
发文量
58
期刊介绍: The Spanish Journal of Psychiatry and Mental Health (SJPMH), incorporated into ISSN 1888-9891, is the official scientific publication of the Spanish Society of Psychiatry and Mental Health. The journal focuses on studying mental illnesses, their pathological processes, and their psychosocial consequences, and aims to disseminate scientific advances in all areas related to mental health and illness. SJPMH accepts unpublished works on psychiatry and mental health, including their medical and social implications. The journal provides space for research in the biological, clinical, and psychosocial fields. Manuscripts undergo peer-review by external reviewers before being accepted for publication. SJPMH is indexed in Index Medicus/Medline, IBECS, Social Sciences Citation Index Journal Citation Reports/Social Sciences Edition, and Current Contents/Social and Behavioral Sciences.
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