上海地区精神专科医师对精神障碍患者非自愿住院标准的态度调查

An investigation of involuntary admission criterion for patients with mental disorders in psychiatrists in Shanghai

目的调查上海市精神专科医院精神科医师对精神障碍患者非自愿住院标准的态度。方法对332名精神科医师进行自拟问卷调查。结果超过50%的精神科医师认为"既往发作时有自伤史、治疗依从性差、生活自理能力差"的复发患者有高自伤风险,而"既往发作时有自伤或伤人行为、言语威胁、体力攻击行为"的复发患者有高暴力伤人风险。71.7%的临床医师认为危险性标准的设置较之前的工作标准更加严格,仅6%的医师认为更加宽松;对于不符合非自愿住院标准的患者,在家属强烈要求的情况下临床医师做出的选择差异较大,通过对不同性别、学历、医院、职称进行分组比较,差异均无统计学意义(P>0.05)。结论在决定精神障碍患者住院与否的问题上,精神科医师对非自愿住院标准的理解差异较大。

Objective To investigate involuntary admission criterion for patients with mental disorders in psychiatrists in Shanghai.Methods A total of 332 psychiatrists were selected and assessed with the self-designed questionnaire.Results There were more than half for the psychiatrists considering that the risk of self-harming for the relapsing patients included a history of self-injury recurrence,poor treatment compliance due to lack of insight,poor self-care ability,and the risk of harming others for the relapsing patients included a history of self-injury or harming others recurrence,threatening speech,physical aggression.There were 71.7% for the psychiatrists considering that dangerousness criterion was stricter than before and there were 6% for the psychiatrists considering that dangerousness criterion was easy.It was obvious for the differences of the arbitrary attitudes of psychiatrists when the relatives insisted that patients who didn ＇t meet the criterion require hospitalization.There were no differences for the above two questions among different hospitals,genders,education levels and professional titles（P〈0.05）.Conclusion It＇s obvious for involuntary admission criterion of the psychiatrists about the problems of patients with mental disorders hospitalized or not.