田国娇,髙茹,邹开庆,易宏,彭述蓉,白静珍,李家忠,李国波,虞慎也,王成英,张霞,张炳智.雅安市精神障碍患者就诊情况及影响因素[J].四川精神卫生杂志,2020,33(5):446-450.Tian Guojiao,Gao Ru,Zou Kaiqing,Yi Hong,Peng Shurong,Bai Jingzhen,Li Jiazhong,Li Guobo,Yu Shenye,Wang Chengying,Zhang Xia,Zhang Bingzhi,Study on the medical visits of patients with mental disorders in Ya'an and its influencing factors[J].SICHUAN MENTAL HEALTH,2020,33(5):446-450

雅安市精神障碍患者就诊情况及影响因素

Study on the medical visits of patients with mental disorders in Ya'an and its influencing factors

投稿时间：2020-06-27

DOI：10.11886/scjsws20200627001

中文关键词: 精神障碍卫生服务利用就诊率

英文关键词:Mental disorders Utilization of health services Medical visits rate

基金项目:四川医事卫生法治研究中心项目（项目名称：基于我国现行法律规定下非自愿住院精神分裂症患者出院模式探讨，项目编号：YF17-Y04）；雅安市科技计划项目（项目名称：芦山4.20地震五年后雅安地区精神障碍现况调查及干预对策研究，项目编号：2018yyjskf04）

作者	单位	邮编
田国娇	雅安市第四人民医院，四川雅安 625000	625000
髙茹	雅安市第四人民医院，四川雅安 625000	625000
邹开庆	雅安市第四人民医院，四川雅安 625000	625000
易宏	雅安市第四人民医院，四川雅安 625000	625000
彭述蓉	雅安市第四人民医院，四川雅安 625000	625000
白静珍	雅安市第四人民医院，四川雅安 625000	625000
李家忠	雅安市第四人民医院，四川雅安 625000	625000
李国波	雅安市第四人民医院，四川雅安 625000	625000
虞慎也	雅安市第四人民医院，四川雅安 625000	625000
王成英	雅安市第四人民医院，四川雅安 625000	625000
张霞	雅安市第四人民医院，四川雅安 625000	625000
张炳智	雅安市第四人民医院，四川雅安 625000	625000

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中文摘要:

目的了解雅安市精神障碍患者就诊情况及影响因素，提高雅安市精神卫生服务利用质量。方法采用分层整群随机抽样方法抽取雅安市6县2区9 000名居民作为调查对象，实际共8 876名完成调查。其中符合《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准共1 106例，使用精神卫生服务利用调查表对精神障碍患者的就诊情况进行调查。采用χ²检验及Logistic二元回归对患者就诊情况的影响因素进行分析。结果 1 106例精神障碍患者中，曾到精神卫生专业机构就诊共173例，就诊率为15.64%（标化就诊率为15.62%）。就诊率排名后三位的病种为：物质相关及成瘾障碍（7.92%）、创伤及应激相关障碍（6.12%）、强迫及相关障碍（0.00%）。未就诊而采用自助方式者（求神拜佛、咨询亲友）共42例，其中汉族28例，少数民族14例。居住地为城市（OR=2.36，P<0.01）对精神障碍患者就诊有正向影响，家族史阴性（OR=0.49，P<0.01）、无就诊意愿（OR=0.07，P<0.01）对精神障碍患者就诊有负向影响。结论雅安市精神障碍患者就诊率偏低，就诊方式以精神科住院及门诊就诊为主，居住地、家族史和就诊意愿影响精神障碍患者的就诊。

英文摘要:

Objective To analyze the medical visit status of patients with mental disorders in Ya'an and its influencing factors， so as to improve the utilization of mental health services.Methods A total of 9 000 residents in 6 counties and 2 districts of Ya'an city were selected by stratified cluster random sampling method， of which 8 876 people completed the investigation， and 1 106 patients met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Mental health service utilization questionnaire was adopted to investigate the medical visits of patients with mental disorders， and the influencing factors were analyzed by χ² test and Logistic binary regression.Results Of 1 106 patients with mental disorders， 173 had visited professional institutions， and the medical visits rate was 15.64% （the standardized rate was 15.62%）. The bottom three diseases with low medical visit rate were substance-related and addictive disorder （7.92%）， posttraumatic stress disorder （6.12%） and obsessive-compulsive and related disorder （0.00%）. A total of 42 patients， including 28 cases of Han nationality and 14 cases of minority nationality chose self-help （praying to Buddha， consulting relatives or friends， etc.） rather than medical treatment.Living in urban areas （OR=2.36， P<0.01） had a positive effect on the medical visit of patients with mental disorders， negative family history （OR=0.49， P<0.01） and willingness towards treatment （OR=0.07， P<0.01） had a negative effect on the medical visit of patients.Conclusion The medical visit rate of patients with mental disorders in Ya'an is low， and medical consultations in psychiatric inpatient and outpatient departments are the main treatment methods. Living areas， family history and willingness towards treatment affect the medical visit status of patients with mental disorders.

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