摘要
目的了解社区严重精神障碍患者肇事肇祸发生情况及影响因素,为制定社区严重精神障碍患者的管理和服务相关政策提供依据。方法利用2017年1月至2019年12月在江苏省严重精神障碍管理系统中登记在册的无锡市严重精神障碍患者的档案信息,分析无锡市社区严重精神障碍患者的肇事肇祸发生情况。采用SPSS 19.0软件进行χ^2检验和多因素logistic回归分析。结果共27977例患者纳入分析,其中发生肇事肇祸2008例,肇事肇祸发生率为7.18%。多因素logistic回归分析结果显示,严重精神障碍患者中男性(OR=1.693),中青年年龄组患者(31~40、41~50和51~60岁年龄组OR值分别为1.426、1.360和1.438),有低保者(OR=1.311),诊断分类为精神分裂症(OR=1.590)、分裂情感障碍(OR=1.620)和双相情感障碍(OR=1.643)患者,有攻击或冲动行为史患者(OR=2.117),近3年年平均综合医院就诊1~2、3~4和≥5次者(OR值分别为1.774、2.279和2.869),不同意参加社区管理者(OR=1.707),有精神残疾证者(OR=1.135)和不参加社区康复活动者(OR=1.672)肇事肇祸的风险增加;大专及以上文化程度者(OR=0.719),职业为工人、专业技术人员及退休者(OR值分别为0.559、0.425和0.546),服药时长>20年者(OR=0.708)肇事肇祸风险降低,均有统计学意义(P<0.05)。结论社区严重精神障碍患者的肇事肇祸发生率较高,应重点关注男性、中青年(31~60岁)、家庭贫困、文化水平较低、近3年年平均综合医院就诊频次较高、有精神残疾证、不参加社区康复活动和不参加社区管理的社区严重精神障碍患者,开展有针对性的干预和制定扶持政策。
Objective To understand the prevalence and influencing factors of the troublemaking in patients with severe mental disorders of the communities,and to provide the basis for formulating the management and service policies of the patients with severe mental disorders in the communities.Methods The file information of the patients with severe mental disorders of Wuxi registered in the severe mental disorders management system of Jiangsu Province was used to analyze the condition of troublemaking of the patients with severe mental disorders in the communities of Wuxi,and theχ^2 test and multivariate logistic regression analysis were used to analyze the data,the used software was SPSS 19.0.Results A total of 27977 patients were included in the analysis,2008 cases(7.18%)had troublemaking.The multivariate logistic regression analysis showed that males(OR=1.693),31-40 years old group(OR=1.426),41-50 years old group(OR=1.360),51-60 years old group(OR=1.438),basic living allowance(OR=1.311),schizophrenia(OR=1.590),schizoaffective disorder(OR=1.620),bipolar disorder(OR=1.643),history of aggressive or impulsive behavior(OR=2.117),visiting general hospital in the past three years for 1-2 times per year(OR=1.774),3-4 times per year(OR=2.279),≥5 times per year(OR=2.869),disagreeing to participate in community management(OR=1.707),mental disability certificate(OR=1.135),and not participating in community rehabilitation activities(OR=1.672)increased the risk of troublemaking;education level≥college(OR=0.719),workers(OR=0.559),professional and technical staff(OR=0.425),retiree(OR=0.546)and medication duration>20 years(OR=0.708)reduced the risk of troublemaking,P<0.05.Conclusion The troublemaking incidence of patients with severe mental disorders is high,the target intervention and supportive policy should be performed for the important patients(males,31-60 years old,family poverty,low education level,high average frequency of medical treatment in general hospitals in the past three years,mental disability certificate,not part
作者
李世明
崔凤伟
冯为
吴越
张紫娟
杨雀屏
LI Shi-ming;CUI Feng-wei;FENG Wei;WU Yue;ZHANG Zi-juan;YANG Que-ping(Department of Social Prevention,the Affiliated Wuxi Mental Health Center of Nanjing Medical University,Wuxi,Jiangsu Province 214000,China)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2020年第11期811-815,共5页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
无锡市卫生计生科研面上项目(MS201756)
南京医科大学科技发展基金项目(NMUB2019305)。
关键词
严重精神障碍
肇事肇祸
影响因素
Severe mental disorders
Troublemaking
Influencing factors
