流浪精神病患者合并躯体疾病调查

目的:调查流浪精神病患者合并躯体疾病的情况。方法:回顾性分析1 043例住院流浪精神病患者的临床资料。结果:入组的患者中69%流浪精神病患者伴有躯体疾病,以皮肤软组织损伤(38%)、传染病(25%)和营养不良(15%)为最多。男性患者皮肤软组织损伤、骨折、感染性疾病伴有率明显多于女性(χ2=51.92,P0.001;χ2=5.82,P=0.016;χ2=8.15,P=0.004);女性患者梅毒感染率明显高于男性(χ2=13.42,P0.001)。结论:流浪精神病患者普遍伴有躯体疾病,女性患者性病伴发率高,男性患者躯体损伤、感染性疾病伴发率高。     

住院精神病患者合并糖尿病相关因素分析及护理对策

目的调查住院精神病患者合并糖尿病的情况及护理对策。方法采用自编一般情况调查表,回顾性分析住院精神病患者的资料。结果 2647例住院精神病患者中,合并糖尿病213例,患病率8.05%,为正常人群的3.22倍;长期服抗精神病药易诱发糖尿病,其中又以氯丙嗪、氯氮平尤为显著;合并糖尿病与精神病患者的超重、肥胖、高血脂、高血压等因素相关。结论加强运动疗法,改变饮食结构,密切观察用药情况,开展健康宣教,预防并发症及护理干预尤为重要。     

近10年住院精神病患者26例猝死的临床分析

目的：了解住院精神病患者猝死的原因及特点。方法：采用回顾性查阅病历的方法登记２６例猝死者各项观察项目。结果：１９８７年～１９９７年猝死发生率为１．０４％,首次住院者１２例（４６％）;既往有躯体疾病者１６例（６２％）,２５例使用了精神药物（涉及各类精神药物）,药物使用频度前３位为：氯丙嗪、舒心利及奋乃静,猝死日小剂量用药才１６例（６４％）,用药２周内猝死者１２例（４８％）。结论：猝死除与猝死者本身躯     

住院精神病患者病房内跌倒调查分析及护理对策

目的分析精神病患者病房内跌倒情况及其危险因素,寻求有效防范措施,减少意外发生。方法回顾性调查我院2001～2006年住院的138例精神病患者病房内跌倒发生情况。结果精神分裂症患者、精神疾病伴发躯体疾病、老年人生理机能衰退为跌倒的主要风险因素,并造成不同程度损伤。结论跌倒在精神科病房中常发生,且带来严重后果,应予重视。     

251例女性流浪精神病患者受性侵犯情况

目的调查分析女性流浪精神病患者受性侵犯情况。方法采用受性侵犯情况调查表,以访谈记录和查阅病历资料的方式对广州市民政局精神病院在2011年5月-2012年10月收治的251例女性流浪精神病患者(研究组)受性侵犯情况进行调查,并与同期普通住院患者194例(对照组)作对比。结果①研究组与对照组受性侵犯者分别为88例(35.1%)和11例(占5.7%),两组比较差异有意义(χ2=54.52,P0.01)。②研究组中受侵犯地点为偏僻地69.1%、侵犯人家中12.5%、被侵犯人家中5.7%、其它地方12.7%。侵犯人为陌生人者79.5%、熟悉者20.5%。侵犯方式为诱奸63.6%、强奸36.4%。③88例被性侵犯女性流浪精神病患者中,怀孕21例;乙肝病毒携带者23例、肺结核感染者2例、HIV检查阳性6例、梅毒检查结果阳性11例。结论女性流浪精神病患者受性侵犯情况较严重,性侵犯主要发生于偏僻地,侵犯人主要为陌生人,侵犯方式以诱奸为主。     

52例流浪精神病患者合并妊娠护理对策

<正>精神病是指在各种致病因素的影响下,大脑机能活动发生紊乱,导致认识、情感、行为和意识等精神活动出现不同程度障碍的疾病[1]。女性精神疾病患者因为自知力丧失,流浪在外,生活无着落,生活习惯因此改变,加之处于育龄期女性生理的特殊性,易患传染病或被人强奸或本身有孕流浪在外等。流浪精神病患者妊娠与其家庭、社会及所处环境诸多因素有关,对这类患者采取行之有效的护理对策和安全管理,使她们安全生产、顺利回归社会是精神科医护人     

60例住院老年精神病患者的心理特点及护理

随着医学科学的发展和人们健康水平的提高，人口老龄化日趋突出，老年人口比例不断增加，老年精神病患者也相应增加。笔者对60例老年精神病患者在住院期间的心理特征进行了调查，并提出相应的护理对策。     

Family planning during psychiatric hospitalization.

Ongoing experience with development of family planning programs in psychiatric hospitals suggests that models must be flexible to allow for varying structures and traditions of institutions and for special needs of specific patient populations. However some issues, particularly those related to patients' rights and to usefulness of particular contraceptives, are broadly applicable. Introduction of a family planning program for psychiatric patients is described.     

Catchment area demographic characteristics and rates of state psychiatric hospitalization

This study examines selected demographic characteristics for their associations with rates of state psychiatric hospitalization for each catchment area in Massachusetts. The extent of poverty in each catchment area explains much of the variability in admissions. State planners interested in reducing reliance upon state hospitals should give more attention to catchment area social indicators.     

Delirium during psychiatric admission increases mortality in psychiatric patients during and after hospitalization. A nationwide study from 1995 through 2012

Objective

Delirium is a common acute neuropsychiatric disorder caused by a variety of physical insults. It is commonly associated with a variety of serious adverse outcomes, including elevated mortality. There are few studies of delirium occurring in psychiatric patients, including its mortality. The aim was to determine the psychiatric diagnostic profile of Danish psychiatric inpatients diagnosed with delirium and to compare standardized mortality ratio (SMR) in this group with the Danish population and general psychiatric inpatients from 1995 through 2012.

Methods

All first time ICD-10 diagnoses of delirium among psychiatric inpatients were identified in the nationwide Danish Psychiatric Central Research Register (DPCRR) from 1995 through 2012.

Results

A total of 7179 persons diagnosed with delirium were identified in the DPCRR between 1995 and 2012. Of these patients 40.8% had more than one diagnosis of delirium during the period. We identified three distinct groups, based on the first delirium-diagnosis; unspecified delirium (76.9%), comorbid delirium–dementia (19.8%), and drug-related delirium (3.3%). Use of sedative-hypnotics was noted in 46% of those with drug-related delirium. The SMR of delirious psychiatric inpatients compared to all psychiatric inpatients was stable at 1.7 throughout the time period.

Conclusion

Delirium occurring in psychiatric inpatients is associated with elevated mortality. Sedative-hypnotic agents are commonly involved in drug-related delirium. Particular preventative effort is warranted for patients with a previous history of delirium, as we found approximately 40% with more than one episode of delirium.