著者

Yoshito Hamada Yasuyuki Ohta

出版者

長崎大学

雑誌

長崎大学医療技術短期大学部紀要 (ISSN:09160841)

巻号頁・発行日

vol.9, pp.1-8, 1996-03

被引用文献数

1

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DSM-ⅢRの基準で診断された分裂病者100例に対し,1988年4月~1992年4月の期間に行われた継続的治療を臨床的に評価した.1988年4月から始まった観察期間4年間を外来のみで経過したのは53例(A群),入院を必要としたのは47例(B群)であった.B群はA群より教育水準は有意に高いが,就業率は低く,生活保護費受給率も高かった.この特徴は男性に顕著に現れていた.B群の精神症状や社会適応度もA群より悪かった.1988年4月以前は100例の約80%が入院歴を有していたが,観察期間内の入院率は47%に低下した.B群の入院理由を検討すると,家族の治療的意欲が大きい入院希望や患者自身の短期入院など,精神科施設の積極的な利用が目立った.交通の便が悪い離島においては,精神科医・精神科作業療法士・保健婦の三者による訪問リハビリテーションの実施が臨床的に有効であることについても言及した.We clinically evaluated continuous treatment of 100 patients diagnosed as having schizophrenia according to DSM-III-R for four years from April 1988 to April 1992. During the four-year investigation period, 53 of the patients (Group A) received treatment by visiting as outpatients, while the remaining 47 patients (Group B), required hospitalization. In Group B compared to Group A, the level of education was significantly higher, but the employment rate was lower and the rate of receiving social welfare benefits was higher. These differences were stronger for male patients. Psychiatric symptoms and social adjustment were poorer in' the patients of Group B than those of Group A. Prior to April 1988, 80% of the 100 patients had had the experience of hospitalization, but in the investigation period the rate of hospitalization decreased to 47%. Examining reasons for hospitalization in Group B, positive attitudes towards for the use of psychiatric institutions, such as hospitalization, together with family members' strong hopes for successful treatment and patients' own desire for short-term hospitalization, were seen. We also discuss the clinical advantages of on-visit rehabilitation by a group of a psychiatrist, a occupational therapist and a community nurse on offshore islands where the public transportation system is not very adequate.