广州市东山区3个社区中精神分裂症患者诱发因素的回顾性分析

Induced factors of schizophrenia in three communities of Dongshan district, Guangzhou city: a retrospective analysis

目的:分析社区中精神分裂症患者诱发因素的分布特点。方法:收集保存在街道居委会由职业医师确诊并填写的全国精神防治康复工作统一下发的精神病防治康复登记表、患者的病历以及其他相关的登记表卡,调查对象为广州市东山区3个街道1988-01/2000-12年在广州市全市居民精神疾病普查中确诊的精神分裂症患者522例。男264例,女258例;年龄20～80岁。由作者将522例患者登记表中相应内容转填入自行设计好的调查表,内容包括:姓名、年龄、性别、婚姻状况、精神分裂症的诱发因素如躯体疾病、意外伤害、精神刺激、工作压力等。对性别、年龄、婚姻状况等因素进行比较,并针对精神分裂症患者的高危个体的诱发因素提出早期干预模式。资料分析用卡方检验。结果:①精神分裂症患者522例中有发病诱因270例。其中工作压力诱发者107例占39.6%,精神刺激诱发者118例占43.7%,躯体疾病诱发者33例占12.2%,意外伤害诱发者12例占4.4%。②在主要病因精神刺激和工作压力两类患者中,其发病年龄主要分布在30～49岁,精神刺激诱发者发病年龄在30～39岁占14.4%(39/270),在40～49岁占10.7%(29/270);工作压力诱发者发病年龄在30～39岁占10.7%(29/270),在40～49岁占11.1%(30/270)。③婚姻状况中男性精神刺激的诱因是未婚占64.6%(135/209),女性精神刺激的诱因主要是已婚占59.8%(144/241)、离异占60.6%(20/33)、丧偶占59.3%(16/27)。结论:①本次调查中精神分裂症的诱发因素主要是精神刺激和工作压力,两者所致精神分裂症占患病总人数的83.3%。②发病年龄处在社会危害因子日渐增多的敏感年龄段,即20～56岁、并以30～49岁为最高峰。③婚姻状况是潜在的危险因素,男女在不同婚姻状况中承受着不同的社会压力和心理刺激易诱发精神分裂症。④建议选择社区普通人群作为早期干预的目标人群,筛选出精神分裂症高危个体,以达到有目的地对诱发因素的早期干预。

AIM： To analysiscommunitythe distribution of factors inducing schizophrenia in METHODS： From January 1988 to December 2000, 522 patients with schizophrenia were enrolled from three blocks of Dongshan district,Guangdong city, including 264 male and 258 female, 20 to 80 years of age.All the patients were recruited according to the rehabilitative registration form for prevention and curing of mental diseases supported by state rehabilitative program for preventing and curing mental disease,patient＇s medical record and other records that were preserved in residential committee and written by professional physicians.Correspondent information about the patients was selected and recorded in a self-made questionnaire by the authors, including name, sex, age, marital status,inducible factors of schizophrenia,such as body damage, accidental trauma,mental stimulation, working pressure,etc.Comparison of sex, age and marital status was done among the participants, and early intervention manner was put forward for the inducible factors of schizophrenia in high-risk individuals. Chi-squared test was used for data analysis.RESULTS： ①Among the 522 schizophrenia patients, inducible factors were found in 270 cases, including 107 cases （39.6%） of working pressure,118（43.7%） of mental stimulation, 33（12.2%） of body diseases, and 12（4.4%） of accidental trauma. ②Patients with schizophrenia due to working pressure and mental stimulation were mostly at 30-49 years of age when they fell ill.For the patients with schizophrenia induced by mental stimulation, 14.4%（39/270） patients had onset of schizophrenia at 30-39 years of age, and 10.7%（29/270）at 40-49 years of age.For the patients with schizophrenia due to working pressure, 10.7%（29/270） patients had onset of schizophrenia at 30-39 years of age, and 11.1%（30/270） at 40-49 years of age. For male patients with schizophrenia induced by mental stimulation, 64.9% （135/209） men were unmarried; for female patients,59.8%（144/241） women married, 60.6%（20/33） were divorced, and 59.3%（16/27） beldame a widow.CONCLUSION： In this investigation, two main inducible factors, working pressure and mental stimulation, resulted in 83.3% schizophrenia in 522 patients. More and more people have schizophrenia at a sensitive age of 20-56 years of age,especially at 30-49 years of age, at which, social hazard factors are increasing gradually. Marital status is one of the potential risk factors. Different soeial pressure and mental stimulation on men or women are likely to lead to the occurrence of schizophrenia. It is suggested that to screen high-risk individuals of schizophrenia from community population as target population should be done as soon as possible, for the purpose of performing an early intervention for the inducible factors of schizophrenia.