851例住院酒相关精神障碍患者的临床特征及治疗转归

THE CLINICAL CHARACTERISTICS, TREATMENT AND PROGNOSIS OF 851 CASES DIAGNOSED AS ALCOHOLISM

目的 :探讨酒依赖和酒相关精神障碍的流行病学特点、临床特点、治疗和转归。方法 :收集 1991年 - 2 0 0 1年北京安定医院全部诊断为酒依赖和 或酒相关精神障碍的住院病历 ,制定调查记录表格 ,对调查纪录结果进行汇总、分析。结果 :诊断为酒依赖和 或酒相关精神障碍的住院病历 85 1份 ,占我院总住院人数的 3 33% ( 85 1 2 5 5 4 0 )。自 1996年 ,住院构成比有所增加 ,分别为 :1997年 4 2 7% ( 93例 ) ,1998年 4 0 8% ( 90例 ) ,1999年 3 89% ( 82例 ) ,2 0 0 0年 4 0 2 % ( 94例 )和 2 0 0 1年 4 0 3% ( 10 3例 )。男∶女 =93 4 5∶1。发病年龄为 4 1 38a±s 8 5 6a。诊断为戒断综合征4 5 8例 ( 5 3 82 % ) ,震颤谵妄 12 5例 ( 14 6 9% ) ,伴幻觉 2 85例 ( 33 4 9% ) ,伴妄想 2 14例 ( 2 5 15 % )。治疗措施主要为 :地西泮替代治疗、抗精神病药物治疗、抗抑郁治疗和匿名戒酒互助 12步法治疗。临床完全缓解的占 6 0 % ( 5 16例 ) ,好转占 35 % ( 2 91例 ) ,死亡 1% ( 5例 )。结论 :酒相关精神障碍住院比率近 5a有逐年增加的趋势。住院诊断以戒断综合征。

Objective : To evaluate the epidemiological, clinical, therapeutic and prognostic characteristics of alcoholism in mental hospitals Methods : The medical records of all in-patients diagnosed as alcoholism from 1991 to 2001 were collected and analyzed. Results : 851 cases (accounting for 3 33% of all in- patients) admitted by Beijing Anding Hospital from 1991 to 2001 were diagnosed as alcoholism , showing an increasing admission rate since 1996. The age of the patients was 41 38 a± s 8 56 a, and male : female = 93 45 ∶1. According to DSM-Ⅳ, 458 cases(53 82%)had alcoholic withdrawal syndrome , 125 cases (14 69%) had delirium tremens, 258 cases (33 49%)had alcoholic hallucination and 214 cases (25 15%)had alcoholic delusion. The treatment included: diazepam replacement, antipsychotic and antidepressant therapy . 12 steps of AA principles were also adopted in recent years in psychotherapy. At the time of discharge , 60% met the criteria for full remission, while 35% met partial remission, 1% died. Conclusion : The admission rate of alcoholism in the decade of 1991 to 2001 in Beijing Anding Hospital has increased in recent 5 years . Most of them were admitted for alcoholic withdrawal syndrome , alcoholic hallucination and delusion .