患有慢性疾病的老年精神障碍患者就诊率及影响因素

Study on the treatment rate and influencing factors of senile mental disorder patients with chronic diseases

目的探讨患有慢性疾病的老年（≥60岁）精神障碍患者的进行精神卫生就诊情况及其相关影响因素。方法以DSM-Ⅳ为诊断标准，用《DSM-Ⅳ轴Ⅰ障碍用临床定式检查》（SCID-I／P）作为诊断工具。由调查员对所有调查对象进行询问并填写“河北省精神卫生服务利用条查表”（自编）。对筛选出存在患有慢性疾病的老年（≥60岁）精神患者进行分析。结果有8．8％（49／556）的患有慢性疾病的老年人出现精神症状后就诊，x2检验分析结果显示是否为低保户、自我照顾能力、行动及就诊距离等方面对是否就诊有影响；Logistic回归分析显示是否为低保户、行动能力是就诊的影响因素（P〈0．05）。结论患有慢性疾病的老年精神障碍患者的精神卫生就诊率较低，需进一步完善老年精神障碍患者的精神卫生服务制度。

Objective To investigate mental health visits and related influencing factors in elderly （over 60 years old） mentally ill patients with chronic diseases. Methods ＂Diagnostic and Statistical Manual of Mental Disorders＂ （DSM-Ⅳ） was used as the diagnostic criteria, ＂DSM- Ⅳ axis Ⅰ disorder with clinical definite examination＂ （SCID- I /P） as a diagnostic tool. All subjects were asked by the investigators and filled the self- designed ＂Hebei Mental Health Service Utilization Checklist＂. The mental ill patients over 60 years old with chronic diseases were screened out. Results 8.8% （49/556） of the elderly patients with chronic disease sought for medical service after the appearance of psychiatric symptoms. Chi-square test analysis showed that whether the patient is low income residents, self-care ability, action and clinic distance have impacts on the decision of seeing a doctor. Binary Logistic regression analysis showed that whether the patient was low income residents and the action function were the influencing factors （P 〈 0.05）. Conclusions The rate of mental health visits for elderly patients with mental disorders with chronic diseases is low, and mental health service systems for the elderly patients with mental disorders need to be further improved.