1986-2006年唐山地区精神科住院患者年出院人次与病种变化趋势  

Changes of Psychiatric Discharge Number and Discharge Diagnosis in Tangshan Region in 1986-2006

作　　者：徐广明[1,2] 肖水源[1] 费立鹏[3] 谷岩[2] 张本[2] 李建明[4] 刘振鹏[5] 刘涛 

机构地区：[1]中南大学公共卫生学院,长沙410078 [2]华北煤炭医学院附属开滦精神卫生中心,河北唐山063001 [3]北京回龙观医院北京自杀研究与干预中心,北京100086 [4]华北煤炭医学院应用心理学系,河北唐山063000 [5]唐山市第五医院,河北唐山063000 [6]唐山市心理医院,河北唐山063000

出　　处：《中国心理卫生杂志》2009年第9期643-647,共5页Chinese Mental Health Journal

基　　金：NIMH项目资助(5D43TW007273-02)

摘　　要：目的:了解唐山地区精神科住院患者年出院人次及诊断构成比的变化趋势,为该地区及国内类似地区精神卫生政策发展提供依据。方法:分析唐山地区全部精神病专科医院1986、1996、2001和2006年出院患者的基本信息和诊断类别及其变化情况。结果:唐山地区1986、1996、2001和2006各年度出院的精神科住院患者分别为832、1705、2279和3154人次,区间增长近4倍,估计每5年平均增长速度为1.39。出院患者的诊断分布在4个年度间存在不同。精神分裂症的出院诊断构成比有下降趋势,而物质滥用或依赖、癔症和应激相关障碍的比例增加。结论:唐山地区精神障碍患者住院服务利用在20年间呈快速上升趋势;与县级精神病院相比,市级精神病院提供的住院服务增长显著;物质滥用和老年精神障碍住院治疗需求呈快速上升趋势,但精神分裂症、情感障碍和神经症仍然是精神科住院服务的重点。Objective： To study the changes of psychiatric discharge number and discharge diagnosis among mental institutions in Tangshan region. Methods： Discharge records in 4 calendar years of 1986, 1996, 2001, and 2006 of all 6 local psychiatric institutions in Tangshan region were investigated. Results： Numbers of discharged psychiatric patients in 1986, 1996, 2001, and 2006 were 832, 1705, 2279, and 3154 respectively. The Average Development Rate （ ADR, estimated by the method of dynamic series ） of discharged psychiatric number was estimated at 1.39 every 5-year interval during the period from 1986 to 2006. The increase rate in municipal level psychiatric institutions was significantly greater than that of county-level institutions. The distributions of discharged diagnosis, based on the Chinese system of mental disorder classification, were changed significantly. While there was a slight decrease of the proportions of schizophrenia, substances abuse and addictive disorder, stress related disorders and hysteria were significantly increased. The proportions of discharged patients diagnosed with schizophrenia, mood disorder, and neurosis accounted for over 70% of all the discharged patients. Conclusions： There is a rapid increase of need for psychiatric in-patient services in Tangshan region over the last 20 years, but the actual growth of admission utilization is limited to the municipal level psychiatric hospitals. The in-patient service needs for patients with substance abuse and geriatric mental disorders are rising rapidly, while schizophrenia, affective disorder, and neurosis are still the main clinical tasks faced by psychiatric inpatient services.

关 键 词：精神障碍 诊断构成比 住院服务需求 

分 类 号：R749.05[医药卫生—神经病学与精神病学] R749.04[医药卫生—临床医学]