2015—2022年庆阳市严重精神障碍患者流行现况及服药影响因素分析  

Epidemiological situation and influencing factors of medication in patients with severe mental disorders in Qingyang City from 2015 to 2022

作　　者：田圆 罗雷[1,3] TIAN Yuan;LUO Lei(School of Public Health,Southern Medical University,Guangzhou 510515,China;Guangzhou Municipal Center for Disease Control and Prevention,Guangzhou 510440,China;Qingyang City Disease Control and Prevention Center,Qingyang,Gansu 745000,China)

机构地区：[1]南方医科大学公共卫生学院,广州510515 [2]庆阳市疾病预防控制中心,广州510440 [3]广州市疾病预防控制中心,甘肃庆阳745000

出　　处：《预防医学情报杂志》2025年第1期29-39,共11页Journal of Preventive Medicine Information

摘　　要：目的分析庆阳市严重精神障碍患者流行病学特征及服药治疗的影响因素,为制定精神卫生防治措施提供依据。方法采用描述性流行病学方法,使用SPSS 25.0软件对2015年1月1日至2022年12月31日纳入甘肃省精神卫生监测信息系统的庆阳市在册严重精神障碍患者病例资料进行统计学分析,采用χ^(2)检验、多因素Logistic回归分析患者服药治疗的影响因素,检验水准α=0.05。结果2015—2022年庆阳市在册严重精神障碍患者12063例,男女性别比为1∶1.20,年龄聚集在45~59岁(39.68%),小学文化居多(37.89%),以农民为主(88.22%),大部分已婚(65.61%);报告患病率最高的是正宁县(6.86‰),最低的是西峰区(3.88‰);6类严重精神障碍患者中精神分裂症最多(63.39%),其次为双相情感障碍(12.90%);多因素Logistic回归分析显示,文化程度小学(OR=1.49,P<0.001)、初中(OR=1.49,P<0.001)、高中或中专(OR=1.36,P=0.002)、监护人为配偶(OR=1.24,P<0.001)、初发病年龄18~44岁(OR=1.30,P<0.001)、初发病年龄45~59岁(OR=1.28,P=0.002)、病程10~19年(OR=1.44,P<0.001)、病程≥20年(OR=1.19,P=0.004)、住院次数≥1次(OR=3.60~4.68,P<0.001)和有关锁史(OR=1.77,P=0.011)是患者服药治疗的积极因素,少数民族(OR=0.19,P=0.001)、监护人为亲戚(OR=0.70,P<0.001)和无监护人或其他(OR=0.73,P<0.001)是患者服药治疗的消极因素。结论庆阳市6类在册严重精神障碍患者人口统计学特征构成不同,精神分裂症、双相情感障碍是防治的重点疾病,患者服药受到多因素综合影响,应完善相关服务政策。Objective To analyze the epidemiological characteristics of patients with severe mental disorders in Qingyang City and the influencing factors of medication treatment,to provide evidence for formulating mental health policies and prevention measures.Methods Descriptive statistics were used to statistically analyze the data of patients with severe mental disorders registered in Qingyang City from January 1,2015 to December 31,2022,which were included in the Gansu Province Mental Health Surveillance Information System.Also,χ^(2)tests and multivariate logistic regression was adopted to analyze the factors influencing patients'reception of medication treatment by using SPSS 25.0 software.The significance level was set atα=0.05.Results There were 12063 registered patients with severe mental disorders in Qingyang City,with a male-to-female ratio of 1∶1.20.Most cases aged between 45 and 59 years(39.68%),were married(65.61%),had a primary school education level(37.89%);and were farmers(88.22%).The reported highest prevalence was in Zhengning County(6.86‰)but the lowest was in Xifeng District(3.88‰).Among all the patients with the six categories of severe mental disorders,the number of patients with schizophrenia were the most(63.39%),followed by patients with bipolar disorder(12.90%).Multivariate logistic regression analysis showed that the positive factors for patients'medication treatment were education level of primary school(OR=1.49,P<0.001),junior high school(OR=1.49,P<0.001),and high school or technical secondary school(OR=1.36,P=0.002),spouse as guardian(OR=1.24,P<0.001),initial onset age ranged from 18 to 44 years(OR=1.30,P<0.001),initial onset age ranged from 45 to 59 years(OR=1.28,P=0.002),course of disease lasting 10 to 19 years(OR=1.44,P<0.001)≥20 years(OR=1.19,P=0.004),number of hospitalizations≥1 time(OR=3.60-4.68,P<0.001),and locked history(OR=1.77,P=0.011).Whereas the negative factors for patients'medication treatment were ethnic minorities(OR=0.19,P=0.001),relatives as guardians(OR=0.70,P<0.0

关 键 词：严重精神障碍 流行病学特征 服药依从性 影响因素 

分 类 号：R749[医药卫生—神经病学与精神病学]