流浪精神病人共病人格障碍调查

Personality Disorder of Homelessness Psychiatric Disorder

目的：探讨流浪精神病人人格障碍的共病情况。方法：将来自梅州市第三人民医院和广州市民政局精神病院流浪精神病人864例连续入组，分为肇事肇祸组（ n＝380例）和非肇事肇祸组（ n＝484例），采用自制调查表、人格障碍访谈问卷第2版（SCID－II）对其进行横断面评估。结果：流浪精神病人精神疾病与人格障碍共病率为693．％，在回避型（χ2＝1547．，P＜00．1）、强迫型（χ2＝753．1，P＜00．1）、被动攻击型（χ2＝654．0，P＜00．1）、抑郁型（χ2＝285．9，P＜0．01）、偏执型（χ2＝79．24，P＜00．1）、分裂型（χ2＝11．11，P＜00．1）、分裂样（χ2＝8．43，P＜00．1）、边缘型（χ2＝279．7，P＜00．1）、反社会型（χ2＝169．9，P＜00．1）人格障碍分布上肇事肇祸组与非肇事肇祸组差异显著，精神分裂症组与非精神分裂症组在回避型（χ2＝308．5，P＜00．1）、依赖型（χ2＝92．79，P＜00．1）人格障碍分布上差异显著，在其它人格障碍分布无显著差异（P＞00．5）。结论：精神疾病与人格障碍的共病率很高，在对流浪精神病人的救治中应考虑人格障碍的影响。

Objective：To survey on the comorbidity of personality disorder（PD）with psychiatric disorder on home‐lessness .Methods：A total of 864 patients with homelessness psychiatric disorder were consecutively examined in the Third People＇s Hospital of Meizhou City and Mental hospital of Guangzhou Civil Administration .All subjects inclu‐ding troublemaking group（n=380）and non-troublemaking group（n=484）were investigated with self -made ques‐tionnaire ,SCID- Ⅱ .Results：The comorbidity rate of personality disorder with homelessness psychiatric disorder was 69 3.% .Compared with the non -troublemaking group ,the troublemaking group had significant difference in the avoidant（χ2 =154 7. ,P〈0 0.1） ,depressive（χ2 =28 5.9 ,P〈0 0.1） ,passive-aggressive（χ2 =65 4.0 ,P〈0 0.1） ,obsess‐ive-compulsive（χ2 =75 3.1 ,P〈0 .01） ,paranoid（χ2 =79 .24 ,P〈0 0.1） ,schizoid（χ2 =8 .43 ,P〈0 0.1） ,schizotypal （χ2 =11 1.1 ,P〈0 0.1） ,borderline（χ2 =27 9.7 ,P〈0 0.1） ,antisocial personality disorder（χ2 =16 9.9 ,P〈0 0.5） .There were significant differences in the avoidant（χ2 =30 8.5 ,P〈0 0.1） ,dependent personality disorder（χ2 =9 .279 ,P〈0 0.1）in the schizophrenia and non -schizophrenia group .Conclusion：The personality disorder rate of homelessness psychiatric disorder is very high ,and we should consider the influence of personality disorder in the treatment of homeless psychiatric disorder .