四川5所医院住院老年人精神疾病的分布特征分析

Distribution Characteristics of Mental Disorders in Elderly Inpatients of Five Hospitals in Sichuan

目的了解四川5所精神疾病专科医院住院老年人的精神疾病分布特征。方法采用回顾性调查的方法,以病历为依据,调查四川省成都市、绵阳市、自贡市、泸州和攀枝花市5个地区的5所精神疾病专科医院的住院老年患者的一般人口学资料和病例资料。结果共收集有效数据1 080例,其中精神分裂症占27.4%,器质性精神障碍占36.6%(其中脑功能损害所致的精神疾病占16.8%,老年痴呆占19.8%),心境障碍占21.1%(其中双相障碍占4.2%,抑郁占13.6%,躁狂占3.3%),物质所致的精神障碍占3.2%,神经症占9.3%,其他占2.4%。男性住院老年人物质所致的精神障碍的比率显著高于女性老人,女性住院老人患精神分裂症、心境障碍、神经症的比率显著高于男性老人,器质性精神障碍的性别差异无统计学意义。成都、自贡和攀枝花的3所精神病医院住院老年人罹患脑器质性精神障碍的比率最高,绵阳、泸州的2所医院住院老年人罹患精神分裂症的比率最高。农村住院老年人罹患精神分裂症的比率最高,城市住院老年人患器质性精神障碍的比率最高。低龄老人患精神分裂症的比率最高,高龄老人患脑器质性精神障碍的比率最高,随年龄的增加,住院精神疾病老年患者人数减少。结论 5所住院精神疾病老人排名前3位的疾病类型为器质性精神障碍、精神分裂症和心境障碍,精神障碍类型存在性别、地区、居住地、城乡和年龄的差异。政府部门和医务工作者应针对重点精神障碍加强有针对性的措施。

Objective To understand the distribution characteristics of mental disorders in elderly inpatients of five psychiatric hospitals in Sichuan. Methods Based on medical records, demographic data and clinical data of elderly patients in five psychiatric hospitals in five regions including Chengdu, Zigong, Mianyang, Luzhou and Panzhihua were investigated by retrospective survey method. Results Valid data of 1 080 cases were collected, covering schizophrenia （ 27.4% ）, organic mental disorders （ 36.6% ） （brain damage caused by mental illness, 16. 8%; senile dementia, 19. 8%）, mood disorders （21.1%） （bipolar disorders, 4. 2% ; depression, 13.6% ; mania, 3.3% ） ,substance - induced mental disorders （ 3.2% ）, neurosis （ 9.3% ）, and others （ 2.4% ）. The proportion of substance induced psychotic disorder was significantly higher in elderly male inpatients than in elderly female in patients ; proportions of schizophrenia, mood disorders and neurosis in elderly female inpatients were significant- ly higher than in elderly male inpatients ; the difference in organic mental disorders was not significant. The proportions of organic mental disorders were the highest in hospitals in Chengdu, Zigong and Panzhihua; the proportions of schizophrenia were the highest in hospitals in Mianyang and Luzhou. The proportion of schizophrenia was the highest in the elderly in rural areas, and the proportion of organic mental disorders was the highest in the elderly in urban hospitals. The proportion of schizophrenia was the highest in elderly inpatients at lower a- ges, while the proportion of organic mental disorders was the highest in elderly inpatients at higher ages. With the increase of age, the number of hospitalized patients suffering from mental disease in the elderly decreased. Conclusion The top three mental disorders in the five hospitals are organic mental disorder, schizophrenia and mood disorder. The exist differences with respect to gender, area, residence and age. Governmental depart- ments and medical workers should strengthen targeted measures against critical mental disorders.