1例伴非自杀性自伤行为精神分裂症患者的治疗经验

Treatment experience of a patient with schizophrenia with non-suicidal self-injury behavior

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2023, 50(3)
作者
作者单位

重庆市长寿区第三人民医院 ;
重庆医科大学附属大学城医院 ;

摘要
本文报告一例22岁女性精神分裂症患者,病程8年,因无人监管近4年一直住院,维持治疗药物为癸酸氟哌啶醇注射液(75mg/月肌注)、氯氮平片(50mg/日),其精神症状消失、情绪稳定。2年前开始反复在心理刺激下用出现非自杀性自伤行为(烟头烫伤手臂)。加用舍曲林片(50mg/日)治疗,患者情绪好转,自伤行为无改善。尝试调整舍曲林片、氯氮平片剂量,自伤行为无改善且出现药物不良反应。给予安排院内辅助性就业,观察随访1年患者自伤行为消失,情绪稳定。该案例提示,院内辅助性就业对精神分裂症患者的非自杀性自伤行为存在一定的疗效,且有助于稳定精神分裂症患者情绪症状。现基于此案例展开讨论,为临床上类似患者治疗提供参考。
Abstract
Běnwén bàogào yīlì 22 suì nǚxìng jīngshén fēnliè zhèng huànzhě, bìngchéng 8 nián, yīn wú rén jiānguǎn jìn 4 nián yīzhí zhùyuàn, wéichí zhìliáo yàowù wèi guǐ suān fú pài dìng chún zhùshè yè (75mg/yuè jī zhù), lǜ dàn píng piàn (50mg/rì), qí jīngshén zhèngzhuàng xiāoshī, qíngxù wěndìng.2 Nián qián kāishǐ fǎnfù zài xīnlǐ cìjī xià yòng chūxiàn fēi zìshā xìng zìshāng xíngwéi (yāntóu tàngshāng shǒubì). Jiā yòng shě qū lín piàn (50mg/rì) zhìliáo, huànzhě qíngxù hǎozhuǎn, zì shāng xíngwéi wú gǎishàn. Chángshì tiáozhěng shě qū lín piàn, lǜ dàn píng piàn jìliàng, zì shāng xíngwéi wú gǎishàn qiě chūxiàn yàowù bùliáng fǎnyìng. Jǐyǔ ānpái yuànnèi fǔzhù xìng jiùyè, guānchá suífǎng 1 nián huànzhě zì shāng xíngwéi xiāoshī, qíngxù wěndìng. Gāi ànlì tíshì, yuànnèi fǔzhù xìng jiùyè duì jīngshén fēnliè zhèng huànzhě de fēi zì shā xìng zì shāng xíngwéi cúnzài yīdìng de liáoxiào, qiě yǒu zhù yú wěndìng jīngshén fēnliè zhèng huànzhě qíngxù zhèngzhuàng. Xiàn jīyú cǐ ànlì zhǎnkāi tǎolùn, wèi línchuáng shàng lèisì huànzhě zhìliáo tígōng cānkǎo.展开302 / 5,000翻译结果This article reports a 22-year-old female patient with schizophrenia. The course of the disease was 8 years. She had been hospitalized for nearly 4 years due to unsupervised supervision. The maintenance treatment drugs were haloperidol caprate injection (75mg/month intramuscular injection), clozapine tablets ( 50 mg/day), his mental symptoms disappeared and his mood was stable. 2 years ago, he began to repeatedly experience non-suicidal self-injury behavior (burning his arm from a cigarette butt) under psychological stimulation. After additional treatment with sertraline tablets (50 mg/day), the patients mood improved, but his self-injury behavior did not improve. Tried to adjust the doses of sertraline tablets and clozapine tablets, but the self-injury behavior did not improve and adverse drug reactions occurred. In-hospital auxiliary employment was arranged, and the patients self-injury behavior disappeared and emotional stability was observed and followed up for 1 year. This case suggests that in-hospital assisted employment has a certain curative effect on the non-suicidal self-injury behavior of schizophrenia patients, and helps to stabilize the emotional symptoms of schizophrenia patients. Based on this case, the discussion is now carried out to provide a reference for the treatment of similar patients in clinical practice.
关键词
辅助性就业;非自杀性自伤;精神分裂症;
KeyWord
Assisted employment; non-suicidal self-harm; schizophrenia;
基金项目
页码 574-576
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李振阳,黄颖,叶文莉,王皋茂*. 1例伴非自杀性自伤行为精神分裂症患者的治疗经验 [J]. 国际精神病学杂志. 2023; 50; (3). 574 - 576.

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