Abstract: Background　In December 2004, the project “central subsidy for local management and treatment of severe mental illness” (also known as “686” project) was officially launched. Five hospitals in Hebei, including Hebei Mental Health Center have actively carried out the special work of “unlocking treatment” in Hebei Province, from which hundreds of patients with severe mental illness benefited. Objective　To explore the relationship between medication adherence and social support among locked schizophrenia patients after receiving unlocking treatment，providing a theoretical basis for improving the medication adherence of this population. Methods　This follow-up survey was conducted from October to November 2016. The participants were those locked schizophrenia patients in Hebei Province who received unlocking treatment，a therapy program by 5 hospitals （Hebei Mental Health Center，Huanghua Anding Hospital，Hengshui Jingda Mental Rehabilitation Hospital，Zhangjiakou Shalingzi Hospital and Hengshui Mental Hospital） between November 2006 and March 2012. The status of medication adherence and social support was surveyed by Data of Locked Schizophrenia Patients Receiving Unlocking Treatment Questionnaire，Social Support Rating Scale（SSRS），and Medication Adherence Rating Scale. Results　A total of 87 cases were included. The mean total scores of SSRS of them were much lower than those of the national norms 〔 （24.0±4.8） vs （34.6±3.7）〕 （t=-20.628，P<0.01）．　The medication adherence differed significantly by prevalence of receiving re-locking treatment（P<0.05），but not by sex，age，educational level，marital status，prevalence of somatic disease，prevalence of enjoying the minimum living guarantee，methods for paying the medical expenses（P>0.05）．The prevalence of having good medication adherence was （59±40） %. The medication adherence was positively correlated with the scores of subjective support and objective support and total scores of SSRS（rs=0.328，P=0.002；rs=0.351，P=0.001；rs=0.392，P<0.001），but showed no correlation with utilization of support（rs=0.204，P=0.058）． Conclusion　After receiving unlocking treatment，locked schizophrenia patients showed an significantly increased medication adherence，and social support is a contributing factor involved in the process.

Key words: Schizophrenia, Medication adherence, Social support

摘要： 背景　2004年12月“中央补助地方重性精神疾病管理治疗项目”（又称“686项目”）正式启动。其中，包括河北省精神卫生中心等在内的5家医院在河北省范围内积极开展“解锁救治”专项工作，数百名重性精神疾病患者从中受益。目的　探讨关锁精神分裂症患者经解锁救治后（以下简称“解锁患者”）服药依从性及社会支持系统的关系，为提高其服药依从性提供理论依据。方法　选取2006年11月—2012年3月由河北省精神卫生中心、黄骅安定医院、衡水市京大心理康复医院、张家口沙岭子医院及衡水市精神病院等5家医院在全省范围内开展的“解锁救治”专项工作解救的精神分裂症患者进行回访调查，调查日期为2016年10—11月。采用《解锁患者信息采集表》、社会支持评定量表（SSRS）和简明依从性评定量表，评定其服药依从性及社会支持系统。结果　共纳入87例患者，其SSRS总分为（24.0±4.8）分，低于国内常模（34.6±3.7）分（t=-20.628，P<0.01）。不同性别、年龄、文化程度、婚姻状况、有无躯体疾病、是否为低保户、医疗付费方式者服药依从性比较，差异均无统计学意义（P>0.05）；是否再关锁者服药依从性比较，差异有统计学意义（P<0.05）。患者服药依从性的比例为（59±40）%，患者服药依从性与客观支持、主观支持、SSRS总分呈正相关（rs=0.328，P=0.002；rs=0.351，P=0.001；rs=0.392，P<0.001）；与对社会支持的利用度无相关关系（rs=0.204，P=0.058）。结论　解锁患者整体服药依从性较好，社会支持水平的提高有利于改善解锁患者的服药依从性。

关键词: 精神分裂症, 服药依从性, 社会支持