湖南省浏阳市农村社区精神分裂症患者治疗现状及相关因素  

Treatment status and related factors among patients with schizophrenia in a rural Chinese community

作　　者：张启文[1] 肖水源[2] 周亮[2] 桂立辉[2] 徐慧兰[2] 刘庆武[2] 何晓燕[2] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]中南大学公共卫生学院社会医学与卫生事业管理系,长沙410078

出　　处：《中国心理卫生杂志》2010年第4期241-244,249,共5页Chinese Mental Health Journal

基　　金：世界卫生组织西太区资助项目(WP/2006/CHN/MNH/2.4/001AC02.01.01.AW.03;Rural Mental Health Development)

摘　　要：目的:了解农村社区精神分裂症患者的治疗现状及相关因素。方法:采用分层整群随机抽样方法,从湖南省浏阳市农村社区(37个乡镇)抽取3个乡镇共23个行政村的≥15岁常住人口61165人,进行精神障碍的线索调查。用DSM-Ⅳ-TR轴I障碍定式临床检查病人版(SCID-I/P)对阳性线索者进行诊断,对确诊为精神分裂症的220例患者进行求医行为问卷调查。结果:精神分裂症的治疗率为81.4%,出现精神症状后1月内接受过专科治疗者仅56例(25.5%),3月内接受过治疗者89例(40.5%),1年以上方获得首次专科治疗者46例(20.9%),从未接受专科治疗者41例(18.6%)。慢性起病,无自知力及就诊距离较远的患者接受专科治疗的可能性更低(OR=4.71、9.14、4.32)。结论:农村社区精神分裂症患者缺乏及时的专科治疗,应通过开展精神卫生宣传教育,增强农村社区精神卫生服务水平,提高居民对精神分裂症的知晓水平及获得社区精神卫生服务的能力,以促进农村社区精神分裂症的及早治疗。Objective： To understand treatment status and related factors among patients with schizophrenia in rural communities. Methods： Three towns covering 23 villages were sampled from Liuyang City using stratified- cluster random sampling methods. Clues of schizophrenia were identified among 61165 residents, and 220 patients were diagnosed as schizophrenia by interviewing the Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders- Patient Edition （SCID-I/P） . Results： There were 81.4% （179/220） of patients who accepted any psychiatric treatment. Among the 220 cases diagnosed with schizophrenia, only 56 （25.5%） cases were accepted treatment within 1 month after psychiatric symptoms notified, 89 （ 40. 5% ）, and 46 （ 20. 9% ） were treated within 3 months and 1 year later respectively, and 41 （ 18. 6% ） had never accepted any psychiatric treatment. The patients with latent onset of symptoms, loss of insight, and longer-distance to hospital were less likely to receive psychiatric treatment promptly （ OR =4. 71, 9. 14, and 4. 32 ） . Conclusion： Most patients with schizophrenia in rural com- munity cannot receive proper treatment ＂in time. It is important to enhance the level of mental health services so that the patients with schizophrenia in rural community can be treated timely.

关 键 词：农村卫生 精神分裂症 治疗现状 相关因素 横断面调查 

分 类 号：R749.305[医药卫生—神经病学与精神病学]