摘要
目的:分析酒精所致精神障碍病人出院1年后复饮的影响因素并构建风险预测模型,探讨复饮和认知功能的关系。方法:选择163例酒精所致精神障碍病人为研究对象,依据出院后1年是否复饮分为复饮组和未复饮组,分析复饮的独立影响因素,检验复饮的模型拟合优度及预测效果,比较2组病人的认知功能是否存在差异,讨论复饮对认知功能的影响。结果:163例病人中1年内103例复饮,复饮率为63.19%。饮酒年限、酒精渴求度、抑郁、家庭关怀度、情绪调节度是导致复饮的独立危险因素(OR=1.110~5.882,95%CI=1.063~24.564,P<0.05),学历为独立保护因素(OR=0.311,95%CI=0.132~0.733,P<0.01)。预测模型拟合优度良好(χ2=11.82,P>0.05),ROC曲线下面积为0.966(P<0.01,95%CI=0.943~0.989),灵敏度为88.3%,特异度为96.7%,约登指数为0.850,最佳临界值为0.756,实际应用的正确率为90.2%。复饮组病人在即刻记忆、言语功能、注意功能、延迟记忆维度及认知功能总分均低于未复饮组(P<0.01)。结论:酒精所致精神障碍病人出院后复饮率偏高,临床应重视学历低、饮酒年限长、酒精渴求度强烈、抑郁情绪、家庭关怀度低及情绪调节度弱的病人,构建的风险预测模型对复饮具有良好预测作用,医护人员应通过有效干预降低复饮率而改善病人认知功能。
Objective:To analyze the influencing factors of relapse in patients with alcohol-induced mental disorders after 1 year of discharge,establish a risk prediction model,and explore the relationship between relapse and cognitive function.Methods:A total of 163 patients with alcohol-induced mental disorders were selected as the study subjects.The patients were divided into the repeated drinking group and non-repeated drinking group according to whether they drank again or not 1 year after discharge.The independent influencing factors of repeated drinking were analyzed,the goodness of fit and prediction effect of the model of repeated drinking were tested.The differences of cognitive function were compared between two groups,and the effects of redrinking on cognitive function was investigated.Results:Among 163 patients,103 cases had relapse within 1 year,and the relapse rate was 63.19%.Drinking years,alcohol craving,depression,family caring and emotional regulation were the independent risk factors of relapse(OR=1.110-5.882,95%CI=1.063-24.564,P<0.05),while the educational background was the independent protective factor(OR=0.311,95%CI=0.132-0.733,P<0.01).The fit of prediction model was good(χ2=11.82,P>0.05),and AUC was 0.966(P<0.01,95%CI=0.943-0.989),The sensitivity,specificity,Youden index,optimal critical value and actual application accuracy were 88.3%,96.7%,0.850,0.756 and 90.2%,respectively.The scores of immediate memory,speech function,attention function,delayed memory and cognitive function in the repeated drinking were lower than those in non-repeated drinking group(P<0.01).Conclusions:Patients with mental disorders caused by alcohol have a high rate of relapse after discharge.Clinical attention should be paid to patients with low education,long drinking years,strong alcohol craving,depression,low family care and weak emotional regulation.The constructed risk prediction model has a good predictive effect on relapse.The medical staff should improve the cognitive function of patients by effective intervention to
作者
杨进
蔡露醒
周香云
YANG Jin;CAI Luxing;ZHOU Xiangyun(Department of Substance Dependence,The Third People′s Hospital of Fuyang,Fuyang Anhui 236000,China)
出处
《蚌埠医学院学报》
CAS
2024年第8期1062-1066,共5页
Journal of Bengbu Medical College
关键词
酒精
精神障碍
复饮
模型构建
认知功能
alcohol
mental disorder
repeated drinking
model construction
cognitive function
