| 张雪梅,李博,蔡本静,谭友果,向波,何静,姜启栋,唐坚.四川省泸州市严重精神障碍患者管理现状及病情的影响因素分析[J].四川精神卫生杂志,2025,(2):131-137.Zhang Xuemei,Li Bo,Cai Benjing,Tan Youguo,Xiang Bo,He Jing,Jiang Qidong,Tang Jian,Management status and influencing factors of disease stabilization in patients with severe mental disorders in Luzhou City， Sichuan Province[J].SICHUAN MENTAL HEALTH,2025,(2):131-137 |
| 四川省泸州市严重精神障碍患者管理现状及病情的影响因素分析 |
| Management status and influencing factors of disease stabilization in patients with severe mental disorders in Luzhou City， Sichuan Province |
| 投稿时间：2024-08-13 |
| DOI：10.11886/scjsws20240813003 |
| 中文关键词: 严重精神障碍 管理指标 服药依从性 病情波动 |
| 英文关键词:Severe mental disorders Healthcare management indicators Medication adherence Symptomatic fluctuation |
| 基金项目:泸州市科技计划项目（项目名称：川南地区严重精神障碍患者现状分析，项目编号：2022-ZRK-186） |
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| 中文摘要: |
| 背景 严重精神障碍是致残率高、疾病负担重的重大公共卫生问题，已被纳入公共卫生项目管理体系。然而，关于四川省泸州市严重精神障碍患者的管理现状以及患者病情影响因素的可信性证据有限。目的 了解泸州市严重精神障碍患者管理现状，并分析在管严重精神障碍患者病情变化的影响因素，以期为制定在管严重精神障碍患者病情管理措施提供参考。方法 于2023年3月，提取2017年12月—2022年12月四川省精神卫生服务综合管理平台中接受严重精神障碍管理的泸州市患者的数据，收集患者接受精神卫生服务的情况和病情变化情况。对泸州市严重精神障碍患者管理指标变化情况进行趋势分析，采用Logistic回归分析严重精神障碍患者病情变化的影响因素。结果 本研究共纳入20 232名患者。2017年，泸州市严重精神障碍患者病情稳定率和规范管理率分别为94.89%、79.36%，2022年增长至95.33%、96.92%。规律服药率从最低点2018年的34.42%增长至2022年的86.81%。2022年，精神分裂症患者规律服药率为71.80%，偏执性精神病患者规律服药率为55.26%，分裂情感性障碍患者规律服药率为51.43%。年龄18~39岁（OR=0.613，95% CI：0.409~0.918）、40~65岁（OR=0.615，95% CI：0.407~0.931）、户籍为城镇（OR=0.587，95% CI：0.478~0.720）、规律服药（OR=0.826，95% CI：0.702~0.973）是病情稳定的保护因素；家庭经济贫困（OR=1.712，95% CI：1.436~2.040）、非关爱帮扶对象（OR=1.928，95% CI：1.694~2.193）、未参加社区康复（OR=2.255，95% CI：1.930~2.634）、间断服药（OR=3.893，95% CI：2.548~5.946）是病情波动的危险因素。结论 泸州市严重精神障碍患者病情稳定率、规范管理率以及规律服药率逐年提升，年龄、户籍、经济状况、服药依从性以及社区康复是严重精神障碍患者病情波动的影响因素。 |
| 英文摘要: |
| Background Severe mental disorders represent a major public health concern due to the high disability rates and substantial disease burden， which has garnered significant national attention and prompted their inclusion in public health project management systems. However， credible evidence regarding the current status of disease management and factors influencing disease stabilization among patients with severe mental disorders in Luzhou City， Sichuan Province， remains limited.Objective To investigate the current management status of patients with severe mental disorders in Luzhou City， Sichuan Province， and to analyze influencing factors of disease stabilization among patients under standardized care， so as to provide evidence-based insights for developing targeted management strategies to optimize clinical interventions for this patient population.Methods In March 2023， data were extracted from the Sichuan Mental Health Service Comprehensive Management Platform for patients with severe mental disorders in Luzhou City who received management between December 2017 and December 2022. Information on mental health service utilization and clinical status changes was collected. Trend analysis was conducted to evaluate temporal changes in key management indicators for severe mental disorders in Luzhou City. Logistic regression analysis was employed to identify factors influencing the disease stabilization or fluctuation of these patients.Results This study enrolled a total of 20 232 patients. In Luzhou City， the stabilization rate and standardized management rate of severe mental disorders were 94.89% and 79.36% in 2017， respectively， which increased to 95.33% and 96.92% by 2022. The regular medication adherence rate rose from 34.42% in 2018 to 86.81% in 2022. In 2022， the regular medication adherence rate was 71.80% for schizophrenia， 55.26% for paranoid psychosis， and 51.43% for schizoaffective disorder. Multivariate analysis identified the following protective factors for disease stabilization： age of 18~39 years （OR=0.613， 95% CI： 0.409~0.918）， age of 40~65 years （OR=0.615， 95% CI： 0.407~0.931）， urban residence （OR=0.587， 95% CI： 0.478~0.720）， and regular medication adherence （OR=0.826， 95% CI： 0.702~0.973）. Risk factors for disease fluctuation included poor （OR=1.712， 95% CI： 1.436~2.040）， non-inclusion in care-support programs （OR=1.928， 95% CI： 1.694~2.193）， non-participation in community rehabilitation （OR=2.255， 95% CI： 1.930~2.634）， and intermittent medication adherence （OR=3.893， 95% CI： 2.548~5.946）.Conclusion The stability rate， standardized management rate， and regular medication adherence rate of patients with severe mental disorders in Luzhou City have shown a year-by-year increase. Age， household registration status， economic condition， medication compliance， and community-based rehabilitation were identified as influencing factors for disease fluctuation in these patients. ［Funded by Luzhou Science and Technology Plan Project （number， 2022-ZRK-186）］ |
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