社区精神病性障碍患者危险性及影响因素分析  

Study on the risks and its influencing factors of patients with psychotic disorders in communities

作　　者：罗邦安[1] 秦露露 周蔚 付文彬[1] 刘禹辰 王东欣 李小松 Luo Bang＇an,Qin Lulu,Zhou Wei,Fu Wenbin,Liu Yuchen,Wang Dongxin,Li Xiaosong(1.Department of Mental Health , the Brain Hospital of Hunan , Changsha 410007, China ;2.Department of Social Medicine and Health Management,Medical School of Hunan Normal University, Changsha 410013, China ;3. Institute of Hospital Management, Xiangya Hospital, Central South University, Changsha 410008, China)

机构地区：[1]湖南省脑科医院精神卫生中心,长沙410007 [2]湖南师范大学医学院社会医学与卫生事业管理系,长沙410013 [3]中南大学湘雅医院医院管理研究所,长沙410008

出　　处：《中华行为医学与脑科学杂志》2018年第2期178-182,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家社会科学基金项目（17CGL050）

摘　　要：目的了解社区精神病性障碍患者危险性及其影响因素。方法采用多阶段分层整群随机抽样方法，调查了457名社区精神病性障碍患者。结果精神病性障碍患者中，危险性0级200人（43．8％），1级113人（24．7％），2级85人（18．6％），3级43人（9．4％），4级11人（2．4％），5级5人（1．1％），有危险的患者总计257人，占56．2％。不同性别、家庭月经济收入、病程、疾病类型、服药情况和既往暴力行为史的患者的危险性分布差异有统计学意义；Logistic回归分析显示，家庭月经济收入低（OR=0．515，95％CI=0．386-0．689，P〈0．01）、病程长（OR=1．378，95％CI=1．179-1．609，P〈0．01）、精神分裂症患者（OR=6．285，95％CI=2．456-16．086，P〈0．01）、既往有暴力行为史（OR=28．988，95％CI=10．692-78．592，P〈0．01）是精神病性障碍患者危险性的影响因素。结论家庭月经济收入低、病程长、精神分裂症、既往有暴力行为史是社区精神病性障碍患者危险性的影响因素，要加强对这些患者的随访管理和监护力度。Objective To explore the risks and its influencing factors of patients with psychotic disorders in communities.Methods A total of 457 patients with psychotic disorders in communities were investigated by use of the multistage stratified cluster random sampling method.Results Totally 257 patients with psychotic disorders in communities were with risks, which accounted for 56.2%. Among them, 200 patients （43.8%） were with level-0 risk, 113 patients （24.7%） were level-1 risk, 85 patients （18.6%） were level-2 risk, 43 patients （ 9.4% ） were level-3 risk, 11 patients （ 2.4% ） were level-4 risk, while 5 patients （ 1.1% ） were level-5 risk.There were significant differences in risks among patients with different gender,family income, duration, type of disease, medication and the history of violent behavior. Logistic regression analysis showed that low family income （ OR= 0.515,95% CI= 0.386-0.689, P〈0.01 ） ,long course of disease （ OR= 1.378,95%CI= 1.179-1.609, P〈0.01 ）, patients with schizophrenia （ OR= 6.285,95%CI= 2.456-16.086, P〈 0.01） and patients with a history of violence history （OR= 28.988,95%CI= 10.692-78.592, P〈0.01 ） were the risk factors of the influencing of patients with psychotic disorders in communities. Conclusions Low family income,long course of disease,patients with schizophrenia and a history of violence history are the influencing factors of patients with psychotic disorders in communities, and the management of follow-up and the strength of supervision among these patients should be reinforced.

关 键 词：精神病性障碍 危险性 影响因素 

分 类 号：R749[医药卫生—神经病学与精神病学]