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.
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。