湖南省纳入与未纳入严重精神障碍信息系统的患者特征

Characteristics of severe mental disorders patients included and not included in the Information System in Hunan Province

目的:了解湖南省未被纳入严重精神障碍信息系统的患者特征。方法:采用多阶段分层整群随机抽样方法,获得合格调查对象89 465人,由培训合格的调查员用一般健康问卷(GHQ-12)和行为异常线索访谈进行筛查,完成72 999人(81.6%)。精神科医生对6082例有高、中度风险或精神症状的疑似患者进行SCID-I访谈作出诊断。以符合诊断标准的严重精神障碍患者作为研究对象,用患者姓名和家庭住址等信息在湖南省严重精神障碍信息系统中进行检索,确定纳入系统的患者,并与未纳入系统的患者进行比较。结果:720例严重精神障碍患者中,有378(52.5%)例未纳入系统。患者纳入系统的二分类logistic回归分析显示,离异和丧偶者、检出率较低地区患者、从未求助者更可能不被纳入到系统。结论:湖南省严重精神障碍患者的纳入比例还有待提高。

Objective:To understand the characteristics of patients who were not included in the severe mental disorder Information System in Hunan Province.Methods:Using multi-stage stratified cluster random sampling method,89 465 persons were sampled out.Qualified trained investigators screened the participants using the General Health Questionnaire(GHQ-12) and behavioral abnormalities cue interviews,and 6082 ones with high or moderate risks based on GHQ-12 or showed possible psychiatric symptoms based on behavioral abnormalities cue interviews were interviewed by trained psychiatrists with the Structured Clinical Interview for DSM-IV and formal diagnoses were made.The 720 patients who were diagnosed as having severe mental disorders were included in this study.The personal information was cross-examined with the Information System to identify who were and who were not included in the Information System.Then demographic characteristics,social function,and clinical characteristics of the patients who were included in the System were compared with those who were not included.Results:Among 720 patients with severe mental disorders,378(52.5%) were not included in the system.Unconditional logistic regression analysis showed that those who were divorced or widowed,patients from areas with lower detection rate,and those who had never sought for help were less likely to be included in the System.Conclusion:The proportion of patients with severe mental disorders included in the Information System in Hunan province needs to be improved.