2011年-2013年四川省在管重性精神病患者死亡及死亡原因分析

The state of death and the cause of death insevere psychotic patients who were managed in Sichuan,2011-2013

目的 分析四川省参与社区管理的重性精神病患者死亡变化趋势和死亡原因,探讨降低其死亡的干预措施.方法 对2011年-2013年四川省参与社区管理的重性精神病患者个人基本信息及乡镇（社区）防保医生上门访视的随访信息、失访（死亡）患者登记表进行统计分析.结果 截止2013年12月底四川省参与社区管理的重性精神病患者达17.1万.2011－2013年间其死亡人数为3248人（1.89％）,其中,精神分裂症2757例（84.88％）,精神发育迟滞169例（5.20％）,癫痫所致精神障碍164例（5.05％）,双相情感障碍92例（2.83％）,分裂情感性障碍46例（1.42％）,偏执性精神病20例（0.62％）.各年度死亡率比较,城市与农村比较,差异均有统计学意义（P＜0.01）.其前5位死因依次为：躯体疾病、其他（不明原因死亡）、意外、精神疾病相关并发症及自杀.死亡前得到有效治疗的比例为0.62％ ～ 1.15％.结论 四川省参与社区管理的重性精神病患者死亡率高于普通人群;加强救治和管理是降低其死亡率的关键;提高各级精神卫生专科机构及基层医疗机构的规范化诊治水平,是降低重性精神病患者死亡率的重点.

Objective To analyse the state of death and the cause of death in severe psychotic patients who were managed in Si- chuan. With statistics information, the intervention methods are investigated to reduce the death rate. Methods The fundamental in- formation, additional information and following -up information of patients were statistical｜y analyzed from 2011 to 2013.Results 3248 patients, who account for 1.89% of all managed psychotics, died from 2011 to 2013. 2757 cases were schizophrenics （84.88%）. 169 cases were patients with mental retardation（5.20% ）. 164 cases were epilepsy by people with mental disorders （5.05%）. 92 cases were patients with bipolar disorder （2.83%）. 46 cases were sehizoaffective disorder patients（ 1.42% ）. 20 cases were paranoid psychosis patients （0.62%）. Death rate across years is of statistical significance （P 〈 0.01 ）. The death rate of patients in cities and that of rural patients was different（P 〈 0.01 ）. The five major causes of death were body disease, others, accidents, mental illness related complications and suicide. 0.62% to 1.15% patients were treated effectively before they died. Conclusion The treat- ment and management should be strengthened in order to reduce the mortality of severe psychotics. Better diagnosis and treatment is the key factor to reduce the mortality of severe psychiatric patients.