정신분열병 환자의 재발경고징후에 대한 예비조사

Preliminary Study of Relapse Warning Signs of Schizophrenia

Relapse warning signs(RWS) of schizophrenia are indicators of drug therapy for relapse prevention. The object of this study is to survey RWS of schizophrena and to use them for relapse prevention and education of the patients and their caretakers. The authors interviewed 74 remitted schizophrenic patients w ho had relapsed more than once and 67 patient caretakers. After introducing the concept of the RW S to the subjects, the RWS were investigated using open-ended questions and Early Sign Questionnaire(ESQ). The authors asked several additional questions, such as How long did it take from the appearance of the RWS to the hospitalization ?，, ‘Could you recognize it as RWS ? \ tW hat did you do when the RW S appeared ? ’ and ‘D o you think the RWS were same over each relapse ? ’ . The results were as follows ； A. The RW S obtained from open-ended questions 1) 53(72%) patients and 57(85%) caretakers reported the RWS spontaneously. 2) The patients reported 33 different signs and the caretakers reported 41. Four signs o f anxiety and nervousness, insomnia, irritability and decreased activity were the most frequent ones in both of the patient and caretaker groups. The patients tended to report subjective distress or discomforts whereas the caretakers tended to report changes in outwardly observable behaviors. 3) There were several RWS which were not listed in the ESQ , such as “talkativeness, soliloquy, changes in the appearance of the eyes, attempting to do something unusual, smiling when alone, peculiar behavior and senseless meddling in other people s affairs . B. The RW S obtained from E S Q 48(64.9%) patients and 51(76.1%) caretakers responded to the E SQ. The number of items responded by attending patients was 12.4 土 6.5 and that of caretakers was 9.3 土 3.7. The signs obtained from E S Q were similar to those obtained from open-ended questions. C. The rank order of RW S correlated significantly with that of Herz’s report obtained from American schizophrenic patients and caretakers in 1980. D . 51.3% of the patients and 59.7% of the caretakers responded that it took more than fifteen days from the appearance of RWS to the hospitalization. From these results the authors concluded that it should be possible to prevent schizophrenic relapse to a considerable extent in Korean, if the patients and their caretakers are given the education on the concept of the relapse warning signs and the appropriate coping strategies. The authors suggest to develope a Korean version of ESQ including the items of talkativeness, soliloquy, changes in the appearance of the eyes, attempting to do something unusual, smiling when alone, peculiar behavior and senseless meddling in other people’s affairs”