新冠肺炎疫情期间精神科患者危机状态及其影响因素研究

Crisisstatus and the influencing factors in psychiatric patients during COVID-19 epidemic

目的探讨新冠肺炎疫情期间精神科患者危机状态及其影响因素。方法选择2019年12月-2020年3月医院精神科收治的60例住院患者作为研究对象,根据是否出现暴力、外走、自弃等危机状态风险评估调查结果将患者分为危机组(n=19)和非危机组(n=41),分析新冠肺炎疫情期间精神科患者出现危机状态的情况及其影响因素。结果住院精神病患者中有76.67%(46/60)为偏执性精神病,精神分裂、狂躁、抑郁及其他类型的病症分别占5.00%、3.33%、5.00%、10.00%。单因素和多因素分析显示,家庭人均月收入<3000元、汉密尔顿抑郁自评量表(HAMD)评分评分>13分、汉密尔顿焦虑自评量表(HAMA)评分>13分、功能大体评定量表(GAF)评分≤50分、生活质量量表(SF-36)≤60分是影响住院精神病患者出现暴力、外走、自弃危机状态的独立危险因素(P=0.025、0.016、0.017、0.041、0.028)。危机组和非危机组患者性别、年龄、职业、病程比较,差异无统计学意义(P>0.05)。结论新冠肺炎期间,精神科患者出现暴力、外走、自弃等危机状态的风险变高,社会支持、生活关怀程度低,负面情绪评分高是增加其危机状态的危险因素,可为精神科制定风险防范措施提供帮助。

Objective To explore the crisis status and the influencing factors in psychiatric patients during COVID-19 epidemic.Methods Sixty inpatients who were admitted to psychiatric department of the hospital from December 2019 to March 2020 were enrolled as the research objects.According to the risk assessment results about presence or absence of violence,running away and self-abandonment,they were divided into crisis group(n=19)and non-crisis group(n=41).Crisis status and the influencing factors in psychiatric patients during COVID-19 epidemic were analyzed.Results Of the psychosis inpatients,there were 76.67%(46/60)with paranoid psychosis.The schizophrenia,mania,depression and other types of symptoms accounted for 5.00%,3.33%,5.00%and 10.00%,respectively.Univariate and multivariate analysis showed that monthly household income per capita less than 3,000 yuan,score of Hamilton Depression Scale(HAMD)higher than 13 points,score of Hamilton Anxiety Scale(HAMA)higher than 13 points,score of global assessment function scale(GAF)not higher than 50 points and score of short form 36 health survey(SF-36)not higher than 60 points were independent risk factors of crisis status(suicide,violence,running away)in psychosis inpatients(P=0.025、0.016、0.017、0.041、0.028).There were no significant differences between crisis group and non-crisis group in gender,age,occupation and disease course(P>0.05).Conclusion During the epidemic of novel coronavirus pneumonia,the risk of psychiatric crisis such as violence,walking away and self abandoned has increased.Low level of social support and life care,and high score of negative emotion are risk factors of increasing crisis state,which can provide help for psychiatric department to formulate risk prevention measures.