CAJ | 학술논문

背景随着上海经济的快速发展,流动劳动力的日益增多,流浪精神疾病患者的入院人数上升.然而,国内对此类日益增长的精神疾病患者的特征研究较少.目的比较上海住院流浪精神疾病患者与住院前与家人同住的精神疾病患者的特征.方法对2007年5月-2009年4月期间由当地公安局(n=42)或救助站(n=56)送达上海市嘉定区精神卫生中心住院的98例流浪精神疾病患者进行研究,与98例同期入院的、住院前与家属或监护人同住的非流浪精神疾病患者的特征进行比较.结果两组患者的年龄差异无统计学意义,但其他人口学资料的差异均有统计学意义.与那些住院前和家人同住的精神疾病患者相比,住院的流浪精神疾病患者中较多的为男性(76.5%比59.2%,χ2=6.76,P=0.009)、单身(88.2%比56.1%,χ2=15.91,P<0.001)、来自外省市(84.7%比20.4%,χ2= 83.55,P<0.001)、无收入来源(73.4%比33.7%,χ2=27.66,P<0.001).流浪组和非流浪组70%以上的患者为精神分裂症或其他精神病性障碍.流浪组患者无物质滥用或酒精使用相关问题.两组间唯一有统计学意义的差异是诊断为精神发育迟滞,流浪组有此诊断的患者比例高于非流浪组(18.4%比6.1%,χ2=6.84,P=0.009).流浪组患者更可能伴有躯体疾病(53.1%比 33.7%,χ2=7.50,P=0.006).结论上海流浪精神疾病患者的住院人数正在快速增加.这些患者与由家属送住院的患者以及其他国家的流浪精神疾病患者具有不同的特征.对这类易受伤害的精神疾病患者应制定出不同的治疗和随访策略.
배경수착상해경제적쾌속발전,류동노동력적일익증다,류랑정신질병환자적입원인수상승.연이,국내대차류일익증장적정신질병환자적특정연구교소.목적비교상해주원류랑정신질병환자여주원전여가인동주적정신질병환자적특정.방법 대2007년5월-2009년4월기간유당지공안국(n=42)혹구조참(n=56)송체상해시가정구정신위생중심주원적98례류랑정신질병환자진행연구,여98례동기입원적、주원전여가속혹감호인동주적비류랑정신질병환자적특정진행비교.결과 량조환자적년령차이무통계학의의,단기타인구학자료적차이균유통계학의의.여나사주원전화가인동주적정신질병환자상비,주원적류랑정신질병환자중교다적위남성(76.5%비59.2%,χ2=6.76,P=0.009)、단신(88.2%비56.1%,χ2=15.91,P<0.001)、래자외성시(84.7%비20.4%,χ2= 83.55,P<0.001)、무수입래원(73.4%비33.7%,χ2=27.66,P<0.001).류랑조화비류랑조70%이상적환자위정신분렬증혹기타정신병성장애.류랑조환자무물질람용혹주정사용상관문제.량조간유일유통계학의의적차이시진단위정신발육지체,류랑조유차진단적환자비례고우비류랑조(18.4%비6.1%,χ2=6.84,P=0.009).류랑조환자경가능반유구체질병(53.1%비 33.7%,χ2=7.50,P=0.006).결론 상해류랑정신질병환자적주원인수정재쾌속증가.저사환자여유가속송주원적환자이급기타국가적류랑정신질병환자구유불동적특정.대저류역수상해적정신질병환자응제정출불동적치료화수방책략.
With the rapid development of Shanghai's economy and the gradual increase in the transient workforce,the number of homeless individuals with psychiatric disorders who get hospitalized has been increasing.But there are few assessments of the characteristics of this growing sub-population of psychiatric patients in China.Objectives: Compare the characteristics of homeless persons with mental illnesses who are hospitalized in Shanghai with those of psychiatric inpatients who lived with family members prior to admission.Methods: Ninety-eight homeless individuals with mental illnesses consecutively referred to the Jiading District Mental Health Center for inpatient treatment by the Bureau of Public Security (n=42) or by the local welfare agency (n=56) between May 2007 and April 2009 were enrolled in the study.Their characteristics were compared with those of 98 inpatients at the Center randomly selected from all inpatients admitted over the same period who had lived with family members or guardians prior to admission.Results: There were no differences in the age between the two groups of patients,but there were significant differences in almost all other demographic variables considered.Compared to inpatients who lived with their family,homeless psychiatric inpatients were more likely to be male (76.5% vs.59.2%,χ2= 6.76,P=0.009),single (88.2% vs.56.1%,χ2= 15.91,P<0.001),from other provinces (84.7% vs.20.4%,χ2= 83.55,P<0.001),and without a source of income (73.4% vs.33.7%,χ2=27.66,P<0.001).Over 70% of both homeless and non-homeless patients had schizophrenia or other psychotic disorders.None of the homeless patients had substance abuse or alcohol-related problems.The only diagnosis that was statistically different between groups was mental retardation,which was more common in the homeless group (18.4% vs.6.1%,χ2=6.84,P=0.009).Homeless patients were also more likely to have a concurrent physical disease (53.1% vs.33.7%,χ2=7.50,P=0.006).Conclusions: The number of homeless psychiatric patients hospitalized in Shanghai is rapidly increasing.The characteristics of these patients are quite different from those of patients who are hospitalized on the recommendation of their families,and from the homeless mentally ill in other countries.Different treatment and follow-up strategies must be developed for this vulnerable subgroup of mentally ill individuals.