河北省107例重性精神疾病关锁患者解锁救治前后状况分析  

The status among 107 locked patients with psychoses before and after unlocking and treatment in Hebei province

作　　者：栗克清[1] 严保平[2] 张云淑[2] 孙秀丽[3] 孙建华[2] 韩彦超[4] 桑文华[5] 赵素银[1] 付希光[6] 王策[5] 

机构地区：[1]河北省第六人民医院精神卫生研究所,保定071000 [2]河北省第六人民医院睡眠医学科,保定071000 [3]河北省第六人民医院精神二科,保定071000 [4]河北省第六人民医院中西医结合二科,保定071000 [5]河北省第六人民医院情感障碍二科,保定071000 [6]河北省第六人民医院老年精神一科,保定071000

出　　处：《中华精神科杂志》2016年第2期81-85,共5页Chinese Journal of Psychiatry

摘　　要：目的分析被关锁重性精神疾病患者解锁救治前后状况。方法纳入2006年11月至2012年3月河北省开展的“解锁工程”解救被关锁的重性精神疾病患者107例。采用改编后的解锁患者信息采集表及肇事肇祸危险性评估表、家庭经济状况调查表评估解锁前后一般状况、社会功能、对家属的影响及肇事肇祸危险性行为、经济状况，并进行对比分析。结果（1）107例患者主要关锁手段以铁链（50．5％，54／107）、单独关于房内（23．4％，25／107）为主，导致关锁的原因以经济困难（56．1％，60／107）及缺乏管制能力的监护者（36．4％，39／107）为主；（2）回访时服药治疗者72例（78．3％，72／92），再次关锁者21例（22．8％，21／92）。回访时肇事肇祸危险性行为低于关锁前[4（4，5）与1（0，2），Z=-7．90，P〈0．01]；社会功能状况、服药情况及治疗依从性、对家属的影响等方面均显著改善；家属对患者状况的满意度较解锁时提高[（2．09±2．51）分与（6．03±3．10）分，t=-10．032，P〈0．05]。回访时家庭人均纯收入508元，年，家庭直接经济负担600元，年。结论被关锁重性精神疾病患者经救治后生存状态改善，肇事肇祸危险性行为降低，但造成的家庭负担重，应引起足够重视。Objective Analysis the status before and after treatment of locked psychoses patients. Methods Totally 107 patients with severe mental illness that hospitalized and discharged in the ＂unlocking project＂ launched in Hebei province from November 2006 to March 2012 were the subjects. The general status, social function, the impact on families, troublemaking risky behavior and economic condition before and after the treatment was assessed by a information collection survey after adaptation, a troublemaking risk evaluate scale and a family economic condition survey. Results （1）The main locked means were by chains （50.5%,54/107） and by located inside a family room （23.4% ,25/107）. The main reasons of locked patients were economic difficulties （56.1%,60/107） and lack of regulatory capacity of guardian （36.4%,39/107）. （2）72 cases （78.3%, 72/92） were taking medical therapy and 21 patients （22.8%,21/92） were locked again during the return visit. The troublemaking risky behavior declined after unlocking （4（4, 5） vs. 1（0, 2）, Z=- 7.90, P〈0.05）. The social functional status, medication treatment and compliance, the impact on families and other aspects were improved significantly. Compared to the unlocking period, the family satisfaction on the condition of the patient increased （（2.09±2.5 1） vs. （6.03± 3.10）, t=- 10.032, P〈0.05）. The per-capita net income of household was 508 Yuan per year and the direct economic burden of household was 600 Yuan per year during the return visit. Conclusion The living condition of locked patients with psychoses is improved after unlocking and treatment. The prevalence of troublemaking risky behavior is decreased. Due to the heavy family economic burden, the unlocking and treatment should be paid highly attention.

关 键 词：精神病 肇事肇祸 关锁 社会功能 经济状况 

分 类 号：R749[医药卫生—神经病学与精神病学]