河北省精神障碍伴其他慢性疾病人群就诊情况及影响因素

Mental health service utilization and its influencing factors in patients with mental disorders complicated with other chronic diseases in Hebei Province

目的了解河北省精神障碍伴其他慢性疾病人群精神疾病的就诊情况及分布情况，探讨影响患有慢性疾病的精神障碍患者就诊的相关因素。方法数据来源自2016年河北省第二次精神卫生流行病学调查。此次调查采用多阶段分层整群抽样方法，使用河北省精神卫生中心自制调查问卷对省内10个地市常住居民进行精神卫生服务利用调查。本研究选取患有慢性疾病的精神障碍患者，对其精神疾病就诊情况进行进一步分析。结果在961例研究对象中，有101例患者出现精神症状后进行就诊，就诊率为10．5％。女性就诊率（11．9％）高于男性就诊率（8．7％），农业户口就诊率（12．0％）显著高于城镇户口（6．5％）。此外，不同年龄、距离、婚姻状况、就业情况以及家庭年收人等情况的患者就诊率差异有统计学意义。Logistic回归分析结果显示，距离、婚姻状况、是否是贫困户和低保户是影响精神障碍伴其他慢性疾患者群精神障碍就诊的因素。101例曾经就诊的患者中，有29例（28．7％）患者曾就诊于精神专科医院。结论河北省精神障碍伴其他慢性疾病人群精神卫生服务利用率偏低，大多数有精神卫生服务需求的慢性疾病人群未能享有精神卫生专业服务。

Objective To understand the medical situation and distribution of mental disorders of people with mental disorders and other chronic diseases in Hebei Province, and to explore the relevant factors influencing the treatment of patients with mental disorders accompanied with other chronic diseases. Methods Data came from the second mental health epidemiological survey in Hebei province in 2016. In this survey, a multi-stage stratified cluster sampling method was used to investigate the mental health service utilization of the residents in 10 cities in the province, by using the self-made questionnaire by Hebei Mental Health Center. In this study, patients with mental disorders accompanied with chronic diseases were selected for further analysis of their medical treatment. Results Among the 961 cases, 101 patients chose to have a treatment after they had psychiatric symptoms, with a rate of 10.5%. The attendance rate of female （11.9%） was significantly higher than that of male （8.7%）, and the attendance rate of rural household （12.0%） was significantly higher than that of urban household （6.5%）. In addition, the impact of age, distance, marital status, employment situation and family income on the attendance rate were statistically significant. The results of Logistic regression analysis showed that distance, marital status, whether poor households and subsistence allowances were factors affecting the attendance of people with mental disorders accompanied with chronic diseases. Among the 101 patients who had been treated, 29（28.7%） of them had access to the psychiatric institution. Conclusions The mental health service utilization of mental disorders accompanied with chronic diseases in Hebei Province is relatively low, most mental health services needs of patients with mental disorders accompanied by other chronic diseases failed to receive mental heahh professional services.