上海市某区精神障碍患者病耻感的现状分析

Survey and analysis of current situation and influencing factors of self-stigma among patients with mental disorders in a district of Shanghai,China

【目的】了解精神障碍患者自我病耻感现状其相关影响因素。【方法】采用整群抽样法抽取某区在册在管确诊精神障碍患者3 926人,应用问卷进行一般调查和自我病耻感调查。【结果】精神障碍患者病耻感总分为(32.81±14.41)分。职业、经济状况、涉及暴力的精神症状及行为、自知力、服药依从性、药物不良反应、家庭监护情况、监护人与患者关系、社会参与情况、社会功能与社交因子得分差异有统计学意义(P<0.05)。职业、文化程度、婚姻状况、诊断、既往肇事肇祸和危险行为、涉及暴力的精神症状、自知力、服药依从性、残疾评定、落实监护补助措施、家庭监护、监护人与患者关系、社会参与、社会功能与能力因子得分差异有统计学意义(P<0.05)。职业、婚姻、诊断、涉及暴力的精神症状、自知力、服药依从性、药物不良反应、家庭监护、监护人与患者的关系、社会参与、社会功能与治疗因子得分差异有统计学意义(P<0.05)。根据多元线性逐步回归分析,对病耻感总分影响大小依次为药物不良反应、家庭监护情况、涉及暴力的精神状况及其行为、就业情况、服药依从性、社会功能、社会参与情况。【结论】精神障碍患者病耻感的总体评分较高,病耻感较强。病耻感得分与药物不良反应、家庭监护情况、涉及暴力的精神状况及其行为、就业情况、服药依从性、社会功能、社会参与情况有关。

[Objective]To describe the current situation of self-stigma in patients with mental disorders and investigate its related influencing factors.[Methods]Using cluster sampling method,general situation and self-stigma of 3 926 patients with mental disorders were investigated with a questionnaire.[Results]The average total score of stigma in patients with mental disorders was 32.81±14.41. There were statistically significant differences between social factors and occupation,economic status,mental symptoms and behavior involving violence,insight,medication compliance,adverse drug reactions,family monitoring,relationship between guardian and patient,and social participation and social function. There were statistically significant differences between ability factors and occupation,education level,marital status,diagnosis,past accidents and dangerous behaviors,mental symptoms involving violence,insight,medication compliance,disability assessment,implementation of guardianship subsidy measures,family guardianship,relationship between guardians and patients,and social participation and social function. There were statistically significant differences between treatment factors and occupation,marriage,diagnosis,mental symptoms involving violence,insight,medication compliance,adverse drug reactions,family supervision,relationship between guardian and patient,and social participation and social function. According to multiple linear stepwise regression analysis,factors with influence on the total score of stigma,in descending order,were adverse drug reactions,family monitoring,mental status and behavior involving violence,employment,medication compliance,and social function and social participation.[Conclusion]Patients with mental disorders have a high score of self-stigma,which is related to adverse drug reactions,family monitoring,mental status and behavior involving violence,employment,medication compliance,and social function and social participation.