不同年龄阶段精神分裂症和双相情感障碍患者自杀风险及精神护理差异分析

Comparison of differences in suicide risk and mental care between patients with schizophrenia and bipolar disorder

目的分析精神分裂症和双相情感障碍患者在不同年龄阶段的自杀风险和精神护理的特征及差异,为有自杀风险的精神分裂症和双相情感障碍患者提供更精准的临床护理服务。方法采用精神科护理观察量表(NOSIE)和自杀风险评估量表(NGASR),对2018-8-30-2020-10-06赤峰市安定医院符合美国精神病学会《诊断与统计手册:精神障碍第5版》(DSM-Ⅳ)诊断标准的362例精神分裂症患者和123例双相情感障碍患者进行调查。分析其在不同年龄阶段(<35、35~50和>50岁)精神分裂症和双相情感障碍患者中的差异。采用SPSS 23.0对数据进行两因素方差分析。结果485例患者,在性别(χ2=1.104,P=0.293)、年龄(t=1.632,P=0.103)及受教育年限(t=0.068,P=0.946)方面,差异均无统计学意义。精神分裂症患者的高危自杀风险率为2.76%,双相情感障碍患者的高危自杀风险率为8.94%,组间比较差异有统计学意义,χ2=8.466,P=0.004。精神分裂症患者自杀风险评分为(3.16±2.01)分,低于双相情感障碍患者的(3.67±2.66)分,t=-2.223,P=0.027;精神护理评分为(26.36±14.28)分,与双相情感障碍患者的(27.62±14.76)分比较,差异无统计学意义,t=-0.837,P=0.403。<35岁年龄段,精神分裂症和双相情感障碍患者的自杀风险分数差异无统计学意义,t=0.997,P=0.321;35~50和>50岁2个年龄段,双相情感障碍患者的自杀风险分数大于精神分裂症患者,t=-1.999,P=0.047;t=-2.537,P=0.012。<35、35~50和>50岁3个年龄段,精神分裂症和双相情感障碍患者的精神护理分数差异无统计学意义,均P>0.05。结论双相情感障碍患者的自杀风险更高,精神分裂症患者自杀风险出现随年龄增长而下降的变化趋势,而双相情感障碍患者自杀风险随着年龄增长出现急速上升的变化趋势。

Objective To provide more accurate clinical nursing services for patients with schizophrenia and bipolar disorder who were at risk of suicide.This study explored the characteristics and differences of suicide risk and mental nursing observation between the two groups at different ages.Methods From August 30,2018 to October 6,2020,a total of 362 schizophrenic patients and 123 patients with bipolar disorder in Anding Hospital of Chifeng City,Inner Mongolia,who met the diagnostic and statistical manual of mental disorders-Ⅳ(DSM-Ⅳ)diagnostic criteria,were investigated with psychiatric nursing observation scale nurses’observation scale for inpatient evaluation(NOSIE)and suicide risk assessment scale nurses’global assessment of suicide risk(NGASR).The differences in different age groups(under 35,35-50 and over 50 years old)of patients with schizophrenia and bipolar disorder were analyzed.SPSS 23.0 was used to analyze the data.Results In this survey,data of 485 patients were collected.There were no significant differences in gender(χ2=1.104,P=0.293),age(t=1.632,P=0.103)and years of education(t=0.068,P=0.946).The high-risk suicide risk rate was 2.76%in patients with schizophrenia and 8.94%in patients with bipolar disorder(χ2=8.466,P=0.004).The suicide risk score of patients with schizophrenia was(3.16±2.01),which was lower than that of patients with bipolar disorder(3.67±2.66),t=-2.223,P=0.027.The mental nursing score was(26.36±14.28),which was not significantly different from that of patients with bipolar disorder(27.62±14.76),t=-0.837,P=0.403.There was no suicide risk score for schizophrenia and bipolar disorder within the age range of 35 years old significant difference(t=0.997,P=0.321).In the two age ranges of 35-50 years old and over 50 years old,the suicide risk score of patients with bipolar disorder was significantly higher than that of patients with schizophrenia(t=-1.999,P=0.047),(t=-2.537,P=0.012).There was no significant difference in the mental scores of patients with schizophrenia and bipolar disorder in the three age ranges of under 35,35-50,and over 50 years old.Conclusions The suicide risk of patients with bipolar disorder is higher.The suicide risk of patients with schizophrenia decreases with the increase of age,while the suicide risk of patients with bipolar disorder increases rapidly with the increase of age.