湖南省2014-2016年在管重性精神障碍患者死亡现况及减寿分析  

Mortality Trends and Years of Potential Life Lost of Psychosis in 2014-2016 in Hunan Province

作　　者：唐任之慧 刘学军[2] 付文彬[2] 罗邦安[2] 谌良民[2] 肖水源 杨徐立 TANG Renzhihui;LIU Xuejun;FU Wenbin(Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学,中国湖南长沙410208 [2]湖南省脑科医院,湖南长沙 [3]湖南中医药大学

出　　处：《中国健康心理学杂志》2018年第8期1121-1125,共5页China Journal of Health Psychology

基　　金：湖南省卫生计生委(编号:B2017107)

摘　　要：目的：分析2014-2016年湖南省在管重性精神障碍患者的死亡现况、死亡原因及寿命损失,为重性精神障碍的防治及干预提供科学依据。方法：将2014-2016年间＂国家严重精神障碍信息系统＂中所有死亡个案的性别、发病年龄、死亡原因等信息导出,利用Excel 2016以及SPSS 23.0软件进行数据的处理及分析;应用χ~2检验进行率的比较,采取潜在减寿年数（Potential Years of Life Lost,PYLL）、平均减寿年数（Average Years of Life Lost,AYLL）及潜在减寿率（Potential Years of Life Lost Rate,PYLLR）分析重性精神障碍所致的寿命损失。结果：湖南省2014~2016年在管重性精神障碍死亡个案共计12017例,平均病死率为14.52‰,男性病死率高于女性,有统计学差异（χ~2=6.684,P〈0.05）;死亡患者平均寿命为（60.97±18.18）岁,疾病类型以精神分裂症为主,死亡患者人口学特征方面,以汉族、农民、已婚、小学文化程度、经济水平在当地贫困标准以下者为主;死因主要包括躯体疾病、精神疾病相关并发症、意外、自杀、他杀等,其构成比分别为48.9%、12.7%、9.3%、3.3%、0.2%;初次发病年龄平均为（43.64±21.41）岁,不同类型的重性精神障碍死亡患者的初次发病年龄有统计学意义（F=44.559,P〈0.001）;精神分裂症所致潜在减寿年数最高,为165870.48人年,癫痫所致精神障碍所致潜在减寿率最高,为1096.69‰。结论：湖南省在管重性精神障碍患者的死亡风险及寿命损失明显高于一般人群,降低患者病耻感、营造良好的社会环境并提高精神障碍就医诊疗的可能性是降低其死亡率、提高其健康寿命年的关键所在。Objective：To analyze the mortality trends and years of potential life lost of patients with severe mental disorders in Hunan province from 2014 to 2016,in order to provide a reference for making policy and delivering services.Methods：All information like gender,the age of first onset,the cause of death and so forth on death patients were obtained from＂National Information System for Psychosis＂from 2014 to 2016;Excel 2016 and SPSS 23.0 software were used for data processing and analysis.Chi-square test was used for rate comparison,and Potential Years of Life Lost（PYLL）,Average Years of Life Lost（AYLL）and Potential Years of Life Lost Rate（PYLLR）were used in the analysis of life loss caused by severe mental disorders.Results：By the end of 2016,there were 12017 patients with psychosis registered in Hunan province,and the average case fatality rate was 14.52 ‰,the case fatality rate in male was higher than that in female with a statistically significant difference（χ~2=6.684,P〈0.05）.The average life expectancy of death patients was（60.97±18.18）years old.Patients were mainly suffered from schizophrenia.Death patients mainly included the following characteristics：Han nationality,farmers,married,an education level of primary school,and an economic level below the local poverty standard.Causes of death included physical illness,mental illness related complications,accidents,suicide,homicide,etc.The constituent ratios were 48.9%,12.7%,9.3%,3.3%and 0.2%.The average age of the first onset was（43.64±21.41）years old,which was statistically significant different between different diseases（F=44.559,P〈0.001）.Schizophrenia had the highest potential years of life lost,and mental disorder caused by epilepsy had the highest potential years of life lost rate.Conclusion：The death risk and life loss of patients with severe mental disorders in Hunan province are higher than those in the general population.We should create a better environment and improve the accessibility of medical treat

关 键 词：重性精神障碍 病死率 死因分析 减寿分析 

分 类 号：R749[医药卫生—神经病学与精神病学]