儿童青少年精神障碍患者出院后的困境与挑战  

Post-discharge dilemmas and challenges for children and adolescents with mental disorders

作　　者：沈昶邑 孙亚琳 彭芳 王凡[1] 王彦凤[1] 薛莉莉[1] SHEN Chang-yi;SUN Ya-lin;PENG Fang;WANG Fan;WANG Yan-feng;XUE Li-li(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,East China University of Science and Technology,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心,华东理工大学,200030

出　　处：《临床精神医学杂志》2025年第2期164-168,共5页Journal of Clinical Psychiatry

基　　金：2020年度上海市“医苑新星”青年医学人才培养计划[沪卫人事(2020)087号];2020年度上海市哲学社会科学规划青年课题(2020ESH001);2022年度上海市“医苑新星”青年医学人才培养计划[沪卫人事(2022)65号]。

摘　　要：精神障碍是影响儿童青少年健康的重要因素之一,对儿童青少年及其家庭产生极大的负面影响。目前我国对于儿童、青少年的精神障碍治疗主要依托于医院门诊治疗和住院治疗。由于住院治疗的特殊性,儿童青少年患者出院后往往面临诸多困境。而我国关于儿童青少年患者出院后生存情况的研究较少。为此本文通过对国外相关研究进行综述,总结出了儿童青少年精神障碍患者出院后所面临的4个主要困境:儿童青少年精神健康服务使用的不连续性与障碍;学校环境的适应不良;不稳定的家庭环境;疾病的复发、维持与恶化。基于该结果及国内情况,未来应当开发适合于儿童青少年的延续性护理服务与过渡服务,同时在相关服务设计应加强对于儿童青少年家庭参与的关注,加强“医院、家庭、学校、社区”间的服务联动与信息互通。Mental disorders are one of the most important factors affecting the health of children and adolescents,and have a great negative impact on children and adolescents and their families.At present,the treatment of mental disorders for children and adolescents in China mainly relies on hospital outpatient treatment and inpatient treatment.Due to the special nature of inpatient treatment,children and adolescents often face many difficulties after discharge from the hospital.There are few studies on post-discharge survival of children and adolescents in China.In this regard,this paper summarizes four main dilemmas faced by children and adolescents with mental disorders after discharge from hospital through a review of relevant foreign studies:discontinuity and barriers in the use of mental health services for children and adolescents;maladjustment in the school environment;unstable family environment;and relapse,maintenance and deterioration of the disease.Based on the results and the domestic situation,continuity of care and transition services for children and adolescents in the future should be developed,and more attention to family involvement should be payed in the design of related services,and the linkage and information sharing among"hospital,family,school,and community"should be strengthened.

关 键 词：儿童青少年 精神障碍 出院后困境 建议与应对 

分 类 号：R749.9[医药卫生—神经病学与精神病学]