住院精神疾病患者日常生活能力的转归

The outcome of the activities of daily living in hospitalized psychiatric patients

目的:探讨住院精神疾病患者日常生活能力(ADL)的转归。方法:回顾性分析2015年北京回龙观医院出院的所有精神分裂症、双相障碍和抑郁症患者人口学及临床资料;比较各组患者中文版Barthel指数(MBI-C)入院时和出院时变化。结果:精神分裂症组、双相障碍组和抑郁症组各有1 966例、448例及334例患者入组; 3组间性别、年龄、婚姻状态、住院时间比较差异有统计学意义,双相障碍组平均年龄明显小于其他两组;抑郁症组女性比例明显高于其他两组;精神分裂症组婚姻状态中未婚和离异比例明显高于其他两组,住院时间显著长于其他两组。入院时MBI-C评分3组间差异无统计学意义(F=1. 55,P=0. 213);出院时MBI-C评分及其差值3组间差异有统计学意义(F=20. 32,F=16. 31; P均<0. 001);精神分裂症组出院时MBI-C评分及其差值明显低于双相障碍组及抑郁症组(P均<0. 001),住院时间峰值(79 d)明显多于双相障碍组(23 d)和抑郁症组(15 d)。结论:与精神分裂症患者相比,双相障碍和抑郁症患者能在更少的住院时间内获得更好的ADL转归。

Objective:This study investigated the outcome of the activities of daily living(ADL)in hospitalized psychiatric patients. Method:The demographic and clinical data of all patients with schizophrenia,bipolar disorder and depression who were discharged from Beijing Hui-long-guan hospital in 2015 were analyzed retrospectively,and the changes of the Chinese version of modified Barthel index(MBI-C)at admission and discharge were compared in each group.Results:1966 patients in the schizophrenia group,448 patients in bipolar disorder group and 334 patients in depression group were enrolled.There were significant differences in sex,age,marital status and length of hospitalization between the three groups.The average age of the bipolar disorder group was significantly smaller than that of the other two groups,and the proportion of female in the depression group was significantly higher than that of the other two groups.The proportion of unmarried and divorced in the schizophrenia group was significantly higher than that in the other two groups,and the length of hospitalization in the schizophrenia group was significantly longer than that in the other two groups.There was no significant difference in MBI-C at admission(F=1.55,P=0.213).The MBI-C at discharge and the change of MBI-C were statistically significant between the three groups(F=20.32,F=16.31;P<0.001).The MBI-C at discharge and the change of MBI-C in the schizophrenia group were significantly lower than those in the other two groups(P<0.001).The peak time of hospitalization in schizophrenia group(79 d)was significantly higher than that in bipolar disorder group(23 d)and depression group(15 d).Conclusion:Bipolar disorder and depression can achieve better functional outcomes in less length of hospitalization comparing with schizophrenia.