福州市严重精神障碍患者管理现状研究

Management of patients with severe mental disorders in Fuzhou

目的了解福州市严重精神障碍患者的管理现状,比较城区与非城区精神障碍患者管理现状差异,为精神障碍疾病防控及治疗提供科学依据。方法收集截至2018 年10 月福州市城区及非城区12 个区、县、地级市共30 458 名严重精神障碍患者的资料,包括一般情况、服药情况、管理情况与危险度评估等,采用x2 检验与Fisher 确切概率法比较城区与非城区间严重精神障碍患者各定性资料的差异。结果福州市在册30 458 名严重精神障碍患者中,服药人数23 474 名(77.07%),规律服药人数17 579 名(57.72%),城区服药率及规律服药率均高于非城区;累计管理7 174 名(23.53%),城区管理率较非城区低;城区危险度评估≥ 3 级、持续关锁、病情不稳定、持续不服药发生率均较非城区低,精神发育迟滞(伴发精神障碍)人数占比较非城区高;严重精神障碍患者危害行为(轻度滋事等)与伤害行为(自伤、自杀未遂等)均处于较低水平,分别为0.49%与0.14%。结论福州市严重精神障碍患者总体管理现状良好,但城区与非城区管理现状存在差异,需进一步有针对性地对城区与非城区精神障碍管理进行优化。

Objective To investigate the status quo of the management of patients with severe mental disorders (SMD) in Fuzhou and to compare the difference in management status of SMD patients between urban and non-urban areas, so as to provide scientific evidence for prevention and control of mental disorders. Methods Data including general conditions, drug treatment, management status, and risk assessment results were collected from 30 458 SMD patients in the urban area and non-urban area of Fuzhou, consisting of 12 districts, counties, and prefecture-level cities under Fuzhou. The differences in the qualitative data of these SMD patients between urban and non-urban areas were compared using x2 test and Fisher’s exact test. Results Among the 30 458 SMD patients in Fuzhou, 23 474 (77.07%) were receiving medications and 17 579 (57.72%) were receiving regular medications. The rates of drug use and regular drug use were higher in urban area than in non-urban area. The cumulative number of SMD patients under management was 7174 (23.53%), and the proportion was lower in urban area than in non-urban area. The risk level was ≥3 in the urban area, and the rates of continuous lock-up, unstable condition, and persistent no-drug treatment were lower in urban than in non-urban area, along with a higher number of patients with mental retardation (accompanied by mental disorders). The assault behaviors (e.g. creating mild disturbances) and injury behaviors (e.g. self-injury and attempted suicide) were at low levels (0.49% and 0.14%, respectively). Conclusion SMD patients are well managed in Fuzhou, although there is difference between urban and non-urban areas. Further tailored countermeasures should be taken to optimize the management of SMD patients in both urban and non-urban areas.