225例青少年精神分裂症现状调查及危险因素  

The status quo and risk factors in 225 adolescents with schizophrenia

作　　者：张焱[1] 彭娟[2] 李光芸[1] 聂芸[3] ZHANG Yan;PENG Juan;LI Guang-yun;NIE Yun(Department of Mental Trauma,Wuhan Mental Health Center,Wuhan,Hubei 430000,China)

机构地区：[1]武汉市精神卫生中心心理创伤病区,湖北武汉430000 [2]武汉市精神卫生中心三病区 [3]武汉市精神卫生中心二病区

出　　处：《现代预防医学》2023年第1期103-108,133,共7页Modern Preventive Medicine

基　　金：武汉市医学科研项目(WX20B08)。

摘　　要：目的调查225例青少年精神分裂症现状及其发病危险因素。方法将医院2018年1月至2021年1月间225例首发精神分裂症的青少年住院患者纳为研究对象,调查一般人口学特征、认知功能损害特点、用药现状、生活质量等,并将同期296例同龄健康志愿者纳为对照组,先后行logistic单因素及多因素回归分析,分析影响青少年精神分裂症发病的危险因素。结果225例青少年精神分裂症患者中男性占比70.68%,居住在城市、城镇、郊区及农村者分别占比44.00%、22.22%、23.11%、10.67%,平均受教育年限为(8.91±2.39)年。阳性与阴性症状量表(PANSS)平均得分(67.98±12.03)分,稳定组PANSS量表中阳性量表、一般精神病理学症状量表得分均显著低于首发组(t=6.618,9.573,P<0.001)。成套神经心理状态评估工具(RBANS)量表平均得分(374.31±47.85)分,稳定组RBANS量表中各维度及总得分均显著高于首发组(t=2.846,2.282,3.857,2.452,3.301,3.979,P<0.001)。32.89%的患者接受单一用药,67.11%的患者进行联合用药,患者服药依从性良好,治疗有效率达到99.11%,首发组与稳定组患者的服药种类及用药依从性及用药疗效比较,差异无统计学意义(χ^(2)=0.832,P=0.362,t=0.872,P=0.384,χ^(2)=2.877,P=0.237)。患者世界卫生组织生活质量测定量表简表(WHOQOL-BREF)平均得分(199.03±37.77)分,稳定组量表中各维度及总得分均显著高于首发组(t=2.034,2.203,2.005,2.383,2.083,P<0.05)。多因素logsitic回归分析提示,精神病家族史(OR=11.705,95%CI:3.683~37.203)、幼年不良境遇(OR=7.846,95%CI:1.769~34.799)、病前性格(OR=4.646,95%CI:1.775~12.163)、家庭居住地(OR=1.850,95%CI:1.422~2.405)、近1年LES得分(OR=3.543,95%CI:1.719~7.303)均是影响青少年精神分裂症发病的独立危险因素。结论注重良好家庭氛围的营造,尽量避免对幼儿造成成长创伤,同时关注具有精神病家族史,且性格内向的孩子,及时发现并疏导孩子负面情绪,在�Objective To investigate the status quo and risk factors of schizophrenia in adolescents.Methods A total of 225 adolescents with first-episode schizophrenia from January 2018 to January 2021 hospitalized in Wuhan Mental Health Center were enrolled.Their general demographic characteristics,cognitive impairment characteristics,medication status,and quality of life were investigated.Meantime,another 296 non-psychiatric inpatients of the same age were included as the control group.Logistic univariate and multivariate regression analyses were performed to screen the risk factors affecting the onset of schizophrenia in adolescents.Results Among the 225 adolescent schizophrenia patients,70.68%were males,44.00%were urban residents,22.22%were urban residents,23.11%were suburban residents and 10.67%were rural residents,and the average education years were(8.91±2.39)years.The average score of the Positive and Negative Syndrome Scale(PANSS)was(67.98±12.03).The scores of positive subscale and general psychopathology subscale in PANSS of stable group were significantly lower than those of first-episode group(t=6.618,9.573,P<0.001).The average score of Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)was(374.31±47.85).The scores of each dimension in RBANS scale and total score of the stable group were significantly higher than those of first episode group(t=2.846,2.282,3.857,2.452,3.301,3.979,P<0.001).Among all patients,32.89%of patients received monotherapy,67.11%of patients received combination therapy,and patients had good medication compliance,and the effective rate reached 99.11%.The drug types,medication compliance and efficacy yielded no statistical difference between first-onset group and stable group(χ^(2)=0.832,P=0.362,t=0.872,P=0.384,χ^(2)=2.877,P=0.237).The average score of World Health Organization Quality of Life-BREF(WHOQOL-BREF)was(199.03±37.77).The scores of each dimension in WHOQOL-BREF scale and total score of the stable group were significantly higher than those of first episode

关 键 词：青少年 精神分裂症 疾病现状 发病危险因素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]