突发公共卫生事件下成都市某综合医院儿童青少年精神障碍患者疾病变化趋势分析
Analysis of the disease trends of children and adolescents with mental and psychological disorders in a general hospital in Chengdu under public health emergencies
投稿时间:2023-12-03  修订日期:2024-11-10
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中文关键词:  新冠肺炎疫情  儿童青少年  精神心理疾病
英文关键词:COVID-19  Children and adolescents  Mental and psychological disorders
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作者单位地址
师丽欣 四川大学华西医院 四川省成都市武侯区四川大学华西医院第二门诊部
邱昌建* 四川大学华西医院 四川省成都市武侯区四川大学华西医院第二门诊部
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中文摘要:
      背景 儿童青少年时期是个体心理健康发育的关键阶段,在面对突发公共卫生事件时,儿童青少年的心理应对能力较薄弱,极易出现各种心理问题。目的 了解突发公共卫生事件下 某综合医院心理卫生中心儿童青少年住院患者的疾病构成比变化趋势,为以后类似重大突发公共卫生事件下青少年心理健康研究与干预实践提供参考。方法 选取2018年1月1日—2022年12月31日四川大学华西医院心理卫生中心住院且出院主诊断符合《国际疾病分类(第10版)》(ICD-10)精神分裂症、分裂型障碍和妄想性障碍、抑郁障碍、双相情感障碍 、焦虑障碍、创伤后应激障碍中任一一项诊断标准的6 613例儿童青少年患者为研究对象。回顾性收集住院患者的年龄、性别、民族、居住地、住院天数等信息 ,采用趋势χ2检验考查疾病构成比变化趋势。结果 相比新冠肺炎疫情大流行前,新冠肺炎疫情大流行期间儿童青少年住院患者的年龄更小、住院天数更短,女生占比更大(t=10.743、4.082,χ2=29.092,P均<0.01)。新冠肺炎疫情大流行期间,儿童青少年住院患者抑郁障碍、双相情感障碍、焦虑障碍构成比均呈上升趋势(χ2趋势=11.058、67.333、17.276,P均<0.01),精神分裂症、分裂型障碍和妄想性障碍构成比呈下降趋势(χ2趋势=219.924,P<0.01);0~14岁患者双相情感障碍构成比呈上升趋势(χ2趋势=18.207,P<0.01);15~19岁患者双相情感障碍、焦虑障碍构成比均呈上升趋势(χ2趋势=57.339、19.011,P均<0.01);男生抑郁障碍、双相情感障碍构成比均呈上升趋势(χ2趋势=21.729、11.380,P<0.01);女生双相情感障碍、焦虑障碍构成比均呈上升趋势(χ2趋势=54.830、14.377,P均<0.01)。结论 与新冠肺炎疫情大流行前比较,新冠肺炎疫情大流行期间,综合医院心理卫生中心儿童青少年住院患者主要为女生,年龄偏小、住院时间偏短,儿童青少年住院患者抑郁障碍、双相情感障碍、焦虑障碍构成比均呈上升趋势。
英文摘要:
      Background Children and adolescents are in the critical period of individual mental health development. In the face of public health emergencies, children and adolescents have weak psychological coping ability and are prone to various psychological problems. Objective To understand the changing trend of the disease composition ratio of children and adolescents inpatients in mental health centers of general hospitals under public health emergencies, so as to provide references for future research and intervention practices on adolescent mental health during similar major public health emergencies. Methods From January 1, 2018 to December 31, 2022, the main diagnosis of hospitalization and discharge in the Mental Health Center of West China Hospital, Sichuan University met any of the diagnostic criteria of the International Classification of Diseases, tenth edition (ICD-10), including schizophrenia, schizotype disorder and delusional disorder, depressive disorder, bipolar disorder, anxiety disorder, and post-traumatic stress disorder. A total of 6 613 children and adolescents were included in the study. The age, sex, ethnicity, residence, length of stay and other information of inpatients were collected retrospectively. The trend χ2 test was used to examine the change trend of disease composition ratio. Results There were significant differences in age, length of stay, sex and payment method between children and adolescents before and during the pandemic (t=10.743, 4.082, χ2=29.092, P<0.01). During the COVID-19 pandemic, the proportions of depressive disorder, bipolar disorder and anxiety disorder in hospitalized children and adolescents showed an increasing trend (χ2trend=11.058, 67.333, 17.276, P<0.01). The proportions of schizophrenia, schizotype disorder and delusional disorder showed a decreasing trend (χ2trend=219.924, P<0.01). The proportion of bipolar disorder in hospitalized patients aged 0-14 years showed an increasing trend (χ2trend=18.207, P<0.01). The proportion of bipolar disorder and anxiety disorder in hospitalized patients aged 15 to 19 years was increasing (χ2trend=57.339, 19.011, P<0.01). The proportion of depressive disorder and bipolar disorder in male students increased (χ2trend==21.729, 11.380, P<0.01). The proportion of bipolar disorder and anxiety disorder in girls showed an increasing trend (χ2trend=54.830, 14.377, P<0.01). Conclusion Compared with the pre-pandemic period, during the pandemic period, the inpatients of children and adolescents in mental health centers of general hospitals were mainly girls, with younger age and shorter hospitalization duration, and the proportion of children and adolescents with depressive disorder, bipolar disorder and anxiety disorder showed an increasing trend.
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