精神残疾患者中长期预后的相关因素  

Analysis of related factors of mid-and-long term prognosis in patients with mental disability

作　　者：孙妍[1] 陈薇[1] 刘云[1] 王莉 李鑫 于振剑[1] 梁晓亮[1] 张顺[1] 项亚平 王坤 马文有[1] SUN Yan;CHEN Wei;LIU Yun;WANG Li;LI Xin;YU Zhenjian;LIANG Xiaoliang;ZHANG Shun;XIANG Yaping;WANG Kun;MA Wenyou(Kailuan Mental Health Center,Tangshan 063000,China;North China University of Science and Technology,School of Psychology and Mental Health)

机构地区：[1]开滦精神卫生中心,河北唐山063001 [2]华北理工大学心理与精神卫生学院

出　　处：《中国健康心理学杂志》2023年第5期645-649,共5页China Journal of Health Psychology

基　　金：河北省医学科学研究课题(编号:20201278);开滦科技创新项目(编号:W2022-18)。

摘　　要：目的:探究精神残疾患者中长期预后的相关影响因素,为其中长期预后康复提供一定的科学依据。方法:回顾性收集2016年1月至2018年12月在某院就诊并出院的精神残疾患者病例资料,出院3年后对所有患者进行1次随访,预后情况分为预后良好组和预后不良组;分析两组组间差异,并采用Logistic回归分析影响精神残疾患者预后的独立相关因素。结果:精神残疾患者中长期预后情况良好和不良组间差异比较发现,首次发病年龄、WHO-DASⅡ评分、婚姻状况、职业、受教育程度、居住地、经济条件、吸烟史、多次住院(≥2次)、残疾等级等差异有统计学意义(P<0.05),进一步Logistic回归分析发现,“首次发病年龄”的OR值为0.978(0.963~0.994),“未婚”的OR值为2.247(1.431~3.528),“初中”的OR值为0.619(0.387~0.990),“高中”的OR值为0.516(0.302~0.882),“大专及以上”的OR值为0.385(0.185~0.798),经济条件为“差”的OR值为5.765(2.155~15.424),“多次住院(≥2次)”的OR值为1.905(1.328~2.735),残疾等级为“三级/四级”的OR值为0.264(0.179~0.390)。结论:较小的首次发病年龄、未婚、较低的受教育程度、较差的经济条件、多次住院(≥2次)、较高的残疾等级是精神残疾患者中长期预后质量的危险因素,需要对此类患者加强关注和随访。Objective:To explore the related factors of mid-and-long term prognosis in patients with mental disability,and provide a certain scientific basis for their long-term prognosis and rehabilitation.Methods:The clinical data of patients with mental disability who were hospitalized in our hospital from January 2016 to December 2018 were collected retrospectively,all patients were followed up 3 years after discharge,and patients were divided into two groups according to their prognosis,namely favorable and unfavorable groups.The difference between the two groups was analyzed,and finally Logistic regression was used to analyze the independent related factors affecting the mid-and-long term prognosis.Results:The mid-and-long term prognosis between the two groups was compared.It was found that the age of first onset,WHO-DASⅡscore,marital status,occupation,education,place of residence,economic conditions,smoking history,multiple hospitalizations(≥2 times),disability level were statistically significant(P<0.05).Further logistic regression analysis found that the OR of"the age of first onset"was 0.978(0.963~0.994),the OR of"unmarried"was 2.247(1.431~3.528),and the OR of"junior high school"was 0.619(0.387~0.990),the OR of"high school"was 0.516(0.302~0.882),the OR of"junior college and above"was 0.385(0.185~0.798),and the OR of the economic condition was"bad"was 5.765(2.155~15.424),the OR of"multiple hospitalizations(≥2 times)"was 1.905(1.328~2.735),and the OR of the disability grade of"Level 3/Level 4"was 0.264(0.179~0.390).Conclusion:The independent risk factors for mid-and-long term prognosis include younger age of first onset,unmarried,lower education background,poor economic condition,multiple hospitalization(≥2 times)and higher disability level.

关 键 词：精神残疾 中长期 预后 病例对照研究 

分 类 号：R749.05[医药卫生—神经病学与精神病学]