情緒障礙症個案復元歷程中之社區再融入

Community Reintegration in the Recovery Process for People with Mood Disorders

自1988年起，台灣社區精神復健服務主要在於提供慢性精神病患多元職能治療活動，並以發展社區鄰里服務與促進社會資源利用為主要方向。由於跨領域社區精神醫學專業人員多以思覺失調症為主要服務對象，一般常見的精神疾病（如憂鬱症）個案反而在急性醫療後無法得到所需的持續性服務，尤其缺乏實際連結此類個案於社區穩定生活之服務方案。有鑑於此，本文特以重度憂鬱症個案為例，藉文獻回顧探討心身醫學日間單位中情緒障礙症個案復元模式之長期照護目標及社區再融入之策略，進而分析個案融入社區活動之影響因素，並以案例說明社區再融入方案之五大構面概念及九宮格復元進展評估內容，期使個案於復元歷程中達到回歸社區、自我照顧與獨立生活的終極目標。

Since 1988, the community psychiatric services in Taiwan have been focusing on multi-dimensional occupational activity training for chronic psychiatric patients and the development of regional service and social resource utilization. However, the multidisciplinary psychiatric services mostly target at people with schizophrenia. The need of people with common mental disorders who receive acute care tends to be ignored in the community after discharge. In particular, programs that link between medical service and community care are lacking. Therefore, the article reviewed the literature about strategies of community reintegration and long-term care for people with mood disorders in the recovery process. Taking the example of major depressive disorder, the authors analyzed factors influencing community reintegration for patients in a psychosomatic daycare unit. Further, a case vignette was used to illustrate the five-dimensional conceptual framework of community reintegration and its contents. The ultimate goal of the article was to disseminate a newly developed model to help patients with mood disorders return to the communities with better recovery and to facilitate self-care for more independence in their lives.