深圳市严重精神障碍患者不服药的相关因素  

Related factors of non-medication in patients with severe mental disorders in Shenzhen City

作　　者：彭小冬 毕建强[1] 周志坚[1] 谢海燕[1] 严敬琴 胡赤怡[1] 刘铁榜[1] PENG Xiaodong;BI Jianqiang;ZHOU Zhijian;XIE Haiyan;YAN Jingqin;HU Chiyi;LIU Tiebang(Department of Pubic Health,Shenzhen Mental Health Canter,Shenzhen Kangning Hospital,Shenzhen 518020,Guangdong Provi nce,China)

机构地区：[1]深圳市精神卫生中心,深圳市康宁医院,广东深圳518020

出　　处：《中国心理卫生杂志》2021年第5期353-359,共7页Chinese Mental Health Journal

基　　金：深圳市医疗卫生三名工程(SZSM201512038);深圳市医学重点学科建设经费资助(SZXK072);广东省高水平临床重点专科深圳市配套建设经费资助(SZGSP013)。

摘　　要：目的:分析深圳市社区严重精神障碍患者不服药现状及相关因素,为制定防治措施提供参考。方法:采用描述性分析方法,分析深圳市精神卫生防治工作信息管理系统中截至2019年12月31日在册严重精神障碍患者服药现状。结果:社区严重精神障碍不服药比例为10.4%(3163/30581)。多因素Lo-gistic回归分析显示,已婚(OR=1.22),双相情感障碍(OR=1.67),偏执性精神病(OR=2.22),建档前有危险行为(OR=1.34),病程(OR=1.74~2.03),病情分类(OR=1.63~9.10),自知力(OR=1.72~2.34)为患者服药的危险因素(均P<0.05)。医疗保险支付(OR=0.80),有共同居住者(OR=0.72),精神发育迟滞伴发精神障碍(OR=0.32),有住院治疗(OR=0.32),起病形式(OR=0.83),未治期(OR=0.74~0.80),社区面访(OR=0.33~0.68),申请服药补助(OR=0.07),申请监护补助(OR=0.78)为患者服药的保护因素(均P<0.05)。结论:深圳市社区严重精神障碍患者不服药与人口学特征、临床特征和社区管理情况存在密切相关。Objective:To explore the status and related factors of non-medication in patients with severe mental disorders in Shenzhen, and provide references for the formulation of intervention.Methods:A descriptive analysis method was used to analyze the prevalence of community management of patients with serious mental disorders who were not taking medication in the information management system of mental health prevention and control in Shenzhen as of December 31,2019.Results:The proportion of non-medication in patients with severe mental disorders was 10.4%(3163/30581).Multivariate logistic regression analysis showed that being married(OR=1.22),bipolar disorder(OR=1.67),paranoid psychosis(OR=2.22),risky behaviors before filing(OR=1.34),disease course(OR=1.74-2.03),state of an illness(OR=1.63-9.10),insight(OR=1.72~2.34) were risk factors for patients’ medication(Ps<0.05).While medical insurance payment(OR=0.80),co-residents(OR=0.72),mental retardation with mental disorders(OR=0.32),hospitalization(OR=0.32),onset form(OR=0.83),untreated period(OR=0.74-0.80),community interviews(OR=0.33-0.68),application for medication subsidy(OR=0.07),application for careers allowances(OR=0.78) were protective factors(Ps<0.05).Conclusion:The non-medication of severe mental disorders in the Shenzhen community is closely associated with demographic characteristics, clinical characteristics and community management.

关 键 词：精神障碍 服药依从性 社区管理 

分 类 号：R749.053[医药卫生—神经病学与精神病学]