深圳市宝安区中老年严重精神障碍患者特征及社区管理现状  

Characteristics and community management status of middle-aged and older adults with severe mental disorders in Baoan district,Shenzhen

作　　者：卢楚虹 程娟 卿利 刘成锋[1] 苏海云[1] 林伟权[2] LU Chu-hong;CHENG Juan;QING Li;LIU Cheng-feng;SU Hai-yun;LIN Wei-quan(Department of Mental Health,Shenzhen Bao'an District Hospital for Chronic Disease Prevention and Cure,Shenzhen,Guangdong 518000,China;不详)

机构地区：[1]深圳市宝安区慢性病防治院精神卫生科,广东深圳518000 [2]广州市疾病预防控制中心基本公共卫生部,广东广州510440

出　　处：《中华全科医学》2022年第11期1901-1904,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(72104061)。

摘　　要：目的了解深圳市宝安区中老年严重精神障碍患者的特征和社区管理状况,并探讨影响中老年严重精神障碍患者管理状况的相关因素。方法从深圳市精神卫生防治工作信息管理系统导出截至2021年9月30日宝安区接受管理的年龄≥45岁的中老年严重精神障碍患者的资料。采用logistic回归分析探究中老年严重精神障碍患者管理重要指标(服药依从性、高风险行为)的影响因素。结果共2096例中老年患者纳入分析。深圳市宝安区中老年严重精神障碍患者以女性为主(1248例,59.54%);文化程度偏低,初中及以下文化程度患者占76.00%(1593例);在婚患者较多(1626例,77.58%);多数以直系亲属作为监护人(1913例,91.27%);疾病主要类型为精神分裂症(1411例,67.32%);规律服药率为74.81%(1568例),高风险行为发生率为8.78%(184例)。多因素logistic回归分析结果显示:低收入家庭(OR=1.608,95%CI:1.150~2.249)、与直系亲属共同居住(OR=2.060,95%CI:1.178~3.600)、癫痫所致精神障碍(OR=14.012,95%CI:5.964~32.923)是中老年患者服药依从性的积极因素;年龄60岁以下(OR=1.913,95%CI:1.275~2.871)、非在婚(OR=1.868,95%CI:1.310~2.663)、低收入家庭(OR=1.607,95%CI:1.071~2.411)、其他类型严重精神障碍(OR=47.838,95%CI:10.846~210.986)是中老年患者高风险行为的危险因素。结论建议在城市中老年患者管理中根据患者特点采取有针对性的措施,重点关注60岁以下、低收入、非在婚中老年患者。Objective To investigate the characteristics and community management status of middle-aged and elderly patients with severe mental disorders(SMDs)in Bao'an District,Shenzhen City,and explore the related factors affecting management status.Methods The data of middle-aged and elderly patients with severe mental disorders aged≥45 years under management in Bao'an District were extracted from Shenzhen Mental Health Prevention and Control Information Management System as of September 30,2021.Logistic regression models were used to explore the difference in management indicators(medication compliance and high-risk behaviour)of middle-aged and older adults with SMD.Results A total of 2096 middle-aged and elderly patients were included in the analysis.Most of the middle-aged and older adults(≥45 years)in Bao'an District,Shenzhen were female,accounting for 59.54%(1248 cases).Their educational level was low,76.00%(1593 cases)of them had a junior high school education or below.Most patients were married,accounting for 77.58%(1626 cases).Most of them were taken care of by immediate family,accounting for 91.27%(1913 cases).The main disease type was schizophrenia,accounting for 67.32%(1411 cases).The rate of regular medication was 74.81%(1568 cases),and the incidence of high-risk behaviour was 8.78%(184 cases).Low-income(OR=1.608,95%CI:1.150-2.249),immediate relatives(OR=2.060,95%CI:1.178-3.600)and mental disorders caused by epilepsy(OR=14.012,95%CI:5.964-32.923)were positive factors for medication compliance of middle-aged and older adults with SMD.Less than 60 years of age(OR=1.913,95%CI:1.275-2.871),being unmarried(OR=1.868,95%CI:1.310-2.663),being Low-income(OR=1.607,95%CI:1.071-2.411)and being diagnosed with other serious mental disorders(OR=47.838,95%CI:10.846-210.986)were risk factors for high-risk behaviours.Conclusion Measures should be adopted according to the characteristics of patients in the management of urban middle-aged and older patients,focusing on middle-aged and elderly patients less than 60 years old,L

关 键 词：中老年 严重精神障碍 社区管理 

分 类 号：R749.16[医药卫生—神经病学与精神病学]