首发精神分裂症患者的住院模式分析  

Analysis of Hospitalization Patterns in Patients with First-episode Schizophrenia

作　　者：袁园 熊江容 冉哨东 李道洋 杨龙 刘林宜 YUAN Yuan;XlONG Jiang-rong;RAN Shou-dong;LI Dao-yang;YANG Long;LIU Lin-yi(Mental Health Center of Zhijiang City,Zhijiang 443200,Hubei,China)

机构地区：[1]枝江市精神卫生中心,湖北枝江443200

出　　处：《医学信息》2018年第22期136-137,141,共3页Journal of Medical Information

摘　　要：目的分析《精神卫生法》实施前后5年,首发精神分裂症患者非自愿住院和自愿住院占比有无差异,非自愿住院的主要原因分布及占比有无变化。方法统计2008年1月～2017年12月在我中心住院的首发精神分裂症患者,按前后各5年分为对照组和观察组。10年间,每年随机向60位非自愿住院患者的家属发放调查问卷,了解迫使患者家属为患者选择非自愿住院的最直接原因。结果 10年共入组1728例,对照组904例,观察组824例。对照组中非自愿住院占比为69.58%,观察组为70.75%,数据差异无统计学意义(P>0.05)。两组对象中,非自愿住院的原因分类构成比均依次为:无自知力或者治疗依从性差>伤人行为或者倾向>自伤自杀行为或者倾向>其他,但观察组相较对照组,因伤人行为或倾向而非自愿住院的构成比呈增加(P<0.01),因无自知力或者治疗依从性差而非自愿住院的占比下降(P<0.05)。结论 (1)首发精神分裂症住院患者依然以非自愿住院为主;(2)在《精神卫生法》实施前后5年里,迫使首发精神分裂症患者非自愿住院的原因分类占比排序,均依次为无自知力或治疗依从性差、伤人行为或倾向、自伤自杀行为或倾向、其他;(3)《精神卫生法》的实施后,在非自愿住院的首发精神分裂症患者中,伤人行为或倾向的占比上升,无自知力或者治疗依从性差的占比下降。Objective To compare the admission rate between involuntary hospitalization and voluntary hospitalization of first schizophrenics and analyze the main reason and the ratio of involuntary hospitalization in 5 years before and after implementation of ＂Mental Health Law＂.Methods The first schizophrenia patients hospitalized in our center from January 2008 to December 2017 were divided into control group and observation group according to the 5 years before and after. In the past 10 years, a questionnaire was randomly distributed to the families of 60 involuntary inpatients each year to understand the most direct reason for forcing the family members to choose involuntary hospitalization for patients.Results A total of 1728 patients were enrolled in 10 years, 904 in the control group and 824 in the observation group. The proportion of involuntary hospitalization in the control group was 69.58%, and that in the observation group was 70.75%. There was no significant difference in the data （P〉0.05）. Among the two groups of subjects, the classification of the causes of involuntary hospitalization was in order： no self-awareness or poor treatment compliance〉 wounding behavior or tendency〉 self-injury suicidal behavior or tendency〉 other, but the observation group compared with the control group, The composition ratio of wounded behavior or tendency rather than voluntary hospitalization increased （P〈0.01）, and the proportion of non-intelligence or poor treatment compliance rather than voluntary hospitalization decreased （P〈0.05）. Conclusion （~The first inpatients with schizophrenia are still involuntary hospitalization; ~ln the 5 years before and after the implementation of the ＂Mental Health Law＂, the reasons for the involuntary hospitalization of patients with first-episode schizophrenia are classified as follows： Poor knowledge or treatment compliance, injury behavior or inclination, self-injury suicidal behavior or tendency, others; ~After the implementation of the ＂Mental Health

关 键 词：精神卫生法 首发精神障碍 住院现状 

分 类 号：R749.307[医药卫生—神经病学与精神病学]