48例精神病住院患者自杀相关因素分析

目的 通过分析精神科住院患者的自杀资料,探讨自杀的原因.方法 回顾性调查48例住院期间自杀的精神病患者的病例,对引起自杀的相关因素进行统计学分析.结果 48例自杀患者中女26例,男22例,自杀原因以精神症状、情感障碍、自杀前的不良生活事件为主,分别占自杀原因的42%、29%、13%;常见的自杀方式为自缢16例(33%),过量服药12例(25%),吞食异物8例(17%); 春季自杀24例(13%),秋季15例(31%).结论 住院精神病患者自杀发生具有一定的规律性.     

58例老年住院精神病人的死因及其相关因素分析

鉴于老年精神病人有逐见增多趋势 ,如已占我院总床位数的 2 0 %以上。为此 ,我们试图通过对老年死亡病例的分析 ,以资提高临床诊治水平 ,现报道于后。1　对象和方法1.1　对象　选择 1994年 10月～ 2 0 0 0年 6月住杭州市第七人民医院老年心理康复中心的年龄≥ 6 0岁的老年病人 ,共 919例。1.2　方法　根据研究内容 ,自拟表格 ,由专人进行逐项登记。内容包括性别、年龄、婚姻、职业、费用支付方式、住院次数、住院日、病期 ,遗传史、诊断、合并症、疗效以及死亡原因。所得数据应用ＳＰＳＳ 6 0统计软件包进行统计分析。2　结　　果2 .1　一般…     

综合医院老年住院患者伴发精神症状的相关因素

<正>本研究探讨综合医院老年住院患者伴精神症状相关因素。1对象和方法为2013年1月至2014年2月在北京老年医院住院的年龄65岁、既往无精神疾病史、意识清楚、能完成所有精神科测评的患者;其中240例患者因精神症状而请精神科会诊纳入研究组,参照国际疾病分类第10版诊断标准诊断为抑郁障碍88例(36.7%),焦虑障碍70例(29.2%),躯体化障碍37例(15.4%)、行为障碍26例(10.8%)和其他精神病性障碍     

住院老年精神病患者心理状态及影响因素

本文目的是对住院老年精神病患者心理状态及其影响因素进行综述,为临床改善住院老年精神病患者心理状况、提高治疗效果提供参考。随着人口老龄化程度加深,住院老年精神病患者数量也在持续增加,其心理状态及其影响因素需要得到重视。本文结合近年来相关研究分析住院老年精神病患者的心理状态和影响因素,并进一步探讨干预措施。     

精神科住院患者猝死的相关因素分析

为了探讨精神科临床猝死的规律，对本院住院患者发生的猝死病例进行回顾性研究。     

住院精神分裂症患者安坦应用情况及其相关因素分析

本文对５６０例精神分裂症住院患者的安坦应用情况及其相关因素进行了分析，发现安坦的使用率为６６．４％，其日量为２～１２ｍｇ，平均５．１７±１．７７ｍｇ．应用时间为１～９７０天，平均１５６．１５±１２３．７２天。多元逐步回归分析表明，安坦用量主要与锥体外系副反应、抗精神病药物日量以及住院次数、性别等因素有关，但与发病年龄、疗效等无关。还对安坦与精神分裂症疗效间的关系、服氯氮平患者中安坦的使用情况进行了初步探讨。     

130例住院老年精神障碍患者意外事件发生及相关因素分析

目的 探讨住院老年精神障碍患者意外事件发生及其相关因素,提出干预措施.方法 对2007年9月～2009年12月老年精神障碍患者住院期间出现的意外事件及其相关危险因素进行前瞻性观察研究,对其结果进行统计学分析.结果 研究期间共130例患者入组,发生意外者47例(36.15%),其中各种感染37例,占发生意外者的78.72%,后依次为跌倒4例(8.5%),噎食3例(6.38%),外伤2例(4.26%),骨折1例(2.13%).讨论老年精神障碍患者是发生意外的高危人群,相关因素有年老体弱多病、生活能力缺损、认知能力下降及病房设施缺陷等.因此应重视对老年精神障碍患者住院的护理,做到个体化、人性化和科学化,以免意外发生.     

系统化护理干预对长期住院老年精神障碍患者便秘的影响

目的探讨系统化护理干预对改善长期住院老年精神障碍患者便秘的效果。方法选取符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)和罗马Ⅲ诊断标准的,连续住院时间≥2年,年龄≥65岁的住院精神障碍便秘患者82例,采用随机数字表法分为对照组和干预组各41例。对照组接受常规治疗及护理,干预组除接受常规治疗和护理外,同时进行包括饮食管理、功能锻炼、重建排便习惯等系统化护理干预8周。观察两组排便时间及每周排便次数。结果系统化护理干预8周后,干预组每次排便时间和每周排便次数与对照组比较[(7.39±2.21)min vs.(9.73±1.78)min,(6.46±0.98)次vs.(4.54±0.84)次],差异均有统计学意义(t=5.29、9.58,P均0.01)。结论系统化的护理干预对长期住院老年精神障碍患者便秘可能有效。     

精神障碍非自愿住院患者胁迫体验及其影响因素

目的 初步调查精神障碍非自愿住院患者在入院过程以及住院期间的胁迫体验感知,并 探讨其影响因素。方法 选择2017 年3— 8 月于上海交通大学医学院附属精神卫生中心徐汇院区 的6 个封闭病房内根据《精神卫生法》第三十条要求入住的254 例精神障碍非自愿住院患者,在入院 后的第3 周采用自编的基本情况调查表、简明精神病量表（BPRS）、MacArthur 入院体验主观胁迫分量表 （MPCS）、胁迫体验问卷（CES） 进行问卷调查。根据本次入院前是否征求过本人意见将所有患者分为征求 意见组（115 例）与未征求意见组（139 例）。应用SPSS 22.0 软件进行统计学分析,组间比较采用独立样本 Mann-Whitney 检验或Kruskal-Wallis 检验、χ2 检验, 采用Bonferroni 法校正显著性水平的事后两两比较。 采用相关分析了解MPCS、CES 与BPRS 症状得分的相关性,采用回归分析探索胁迫体验得分的影响因 素。结果 （1）相对精神科的封闭环境,患者的胁迫体验更多源于自我选择和决定权的受限。（2）入院 时未征求意见组患者较征求意见组患者在MPCS 总分［4.00（2.00,5.00）分比1.00（0,2.00）分,Z=8.592, P＜ 0.01］、CES 量表总分［52.00（39.00,81.00）分比44.00（34.00,56.00）分,Z=3.236,P＜ 0.01］及维度分 ［权利限制13.00（9.00,27.00）分比9.00（9.00,15.00）分,Z=3.746,P＜ 0.01;被动14.00（10.00,24.00）分比 12.00（9.00,18.00）分,Z=2.861,P＜ 0.01;负性环境9.00（6.00,13.00）分比8.00（6.00,10.00）分,Z=2.000, P＜ 0.05;负性反应4.00（2.00,6.00）分比3.00（2.00,5.00）分,Z=2.706,P＜ 0.01）］上得分更高。（3）入院 前未征求意见、公安机关送诊、教育程度高是MPCS总分的影响因素（F=25.076,P＜0.01）,经历约束措施、 BPRS 思维障碍严重和入院时胁迫体验高是CES 总分的影响因素（F=5.135,P＜ 0.01）。结论 精神障碍 患者在入院和住院过程中存在一定胁迫体验,这种主观负性体验与多种因素有关,临床上应多加关注, 并采取针对性措施降低患者对胁迫的感知。     

老年脑卒中后抑郁及相关影响因素分析

目的　了解老年脑卒中后抑郁 (PSD)的发生率及与性别、文化程度、病变部位、病灶数目、致残程度的关系 ,对日常生活能力恢复的影响。方法　采用老年抑郁量表对 96例脑卒中患者进行评定 ,分为抑郁组和非抑郁组进行分析比较。结果　共有 44例患者有抑郁症状 ,总发生率为 45 83 % ,女性患者、文化水平偏低、病变部位在左半球及多个病灶者发生率高 ,致残程度与PSD呈正相关。结论　老年PSD发生率高 ,是多种因素共同作用的结果 ,直接影响病人的生存质量及功能恢复。     

Prevalence of and factors associated with psychiatric morbidity in chronic pain patients

Objective

The reported prevalence of psychiatric morbidity in chronic pain patients (CCPs) was high, although it varied tremendously since structured diagnostic instruments were seldom used for diagnosis in previous studies. Study in this area after the launching of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was scarce. This study serves to estimate the prevalence of psychiatric morbidity in patients attending a chronic pain clinic by using the Structured Clinical Interview for DSM-IV (SCID) Axis I disorders and to identify factors highly associated with psychiatric disorders, particularly depression, which is treatable.

Method

Consecutive patients attending a chronic pain clinic were recruited during a 6-month period. Psychiatric diagnoses were made by using the SCID. Logistic regression was used to identify factors predicting overall psychiatric morbidity and depression.

Results

Prevalence of psychiatric disorders in this 89-patient sample was 62.9%. Current major depressive disorder was present in 31.5% and somatoform disorders in 33.7%. Anxiety disorders and current substance use disorders each constituted 18. “Younger age of onset of pain” (odds ratio [OR]=0.956, P<.05) and “higher pain intensity” (OR=1.544, P<.001) were independently associated with presence of psychiatric disorders. “Higher pain intensity” (OR=13.7, P<.05), “negative pain cognition” (OR=0.967, P<.05) and “problems with social and leisure activities” (OR=38.5, P<.05) were associated with depression.

Conclusion

Prevalence of psychiatric disorders in this Chinese chronic pain clinic sample with reference to the DSM-IV was similar to that reported in previous studies. Specific factors were identified to alert pain physicians to underlying psychiatric disorders.     

湖州市住院老年精神障碍患者骨量减少和骨质疏松的发生率及骨密度下降的相关因素(英文)

背景 国内对住院的老年精神障碍患者骨折风险的研究较少。目的 评估老年精神障碍患者的骨密度(bone mineral density, BMD),探明骨密度降低、骨量减少(osteopenia )和骨质疏松(osteoporosis)的相关因素。方法 随机选取湖州市第三人民医院老年科精神障碍住院患者(60岁或以上,诊断为精神分裂症、抑郁症、双相障碍或痴呆)102例。采集患者详细的人口学资料、临床资料、身高和体重指数等,采用双能X射线吸收测定法(dual energy X-ray absorptiometry,DXA)测定腰椎的骨密度。根据世界卫生组织的标准,将低于健康成人平均骨密度1～2.5个标准差者判定为骨量减少,将低于2.5个标准差以上者判定为骨质疏松。结果 骨量减少的发生率为 33.3%(95%CI,24.4%～43.2%),骨质疏松的发生率为 35.3%(26.0%～45.2%),所有这些患者均没有因骨密度降低而接受相应治疗,即便是 5 例曾发生过非外伤性骨折的患者也不例外。女性骨质疏松的发生率是男性的 10 倍(53%比5%)。骨密度随年龄的增加而下降,但随体重指数的增加而增加(患者营养状况改变的结果)。抑郁症患者骨质疏松的发生率(58%)远远高于精神分裂症(33%)、阿尔茨海默病(30%)以及双相障碍(13%)的患者。将骨量减少、骨质疏松患者合并为一组后回归分析发现,低骨密度和合并组均与女性、年龄大、体重指数低及抑郁症诊断独立相关。骨密度下降及骨质疏松与规律服用抗精神病药不相关。结论 骨量减少和骨质疏松是老年精神障碍患者常见的问题,会严重影响其生活质量,但这些问题往往没有得到诊治。需要进一步开展长期的前瞻性研究,以便阐明营养状况、活动量、药物使用及其他因素在精神疾病与骨密度下降之间的病因学通路中所起的重要作用。     

Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk

This study aimed to describe the prevalence of psychiatric disorders and to identify the factors associated with Current Suicide Risk (CSR) in the first trimester of pregnancy. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was employed to diagnose mental disorders in 239 women enrolled in a prospective cohort in Rio de Janeiro, Brazil. Serum lipids, leptin and socio-economic status were the independent variables. CSR, the dependent variable, was entered as binary (yes/no) variable into crude and adjusted Poisson regression models with robust variances. CSR was found to be the main psychiatric syndrome (18.4%), followed by agoraphobia (17.2%), major depressive disorder (15.1%) and generalized anxiety disorder (10.5%). Women with CSR showed higher mean levels of cholesterol (169.2 vs. 159.2; p=0.017), high density lipoprotein (50.4 vs. 47.7; p=0.031) and low density lipoprotein (102.8 vs. 95.6; p=0.022) when compared to women without CSR. The adjusted regression model showed a higher prevalence ratio (PR) of CSR among pregnant women with generalized anxiety disorder (PR=2.70, 95% CI: 1.36–5.37), with ≥two parturitions (PR=2.46, 95% CI: 1.22–4.93), and with major depressive disorder (PR=2.11, 95% CI: 1.08–4.12). We have shown that generalized anxiety disorder, major depressive disorder and higher parity are associated with CSR in the first trimester of pregnancy.     

Prevalence of psychiatric disorders in patients with polycystic ovary syndrome

Objective

To investigate the prevalence of psychiatric disorders among women in ambulatory treatment for polycystic ovary syndrome (PCOS) and to correlate its clinical and demographic aspects with mental disorders.

Methodology

Seventy-two patients in ambulatory treatment at the Endocrinal and Gynaecological Institute of the Federal University of Rio de Janeiro were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of MINI (Mini International Neuropsychiatric Interview, version 4.4). Polycystic ovary syndrome was confirmed according to the ultrasonographic criteria of Adams and by clinical parameters.

Results

Forty-one patients (57%) presented at least one psychiatric diagnosis. Among them, the prevalence of mood disorder reached 78%. The most prevalent diagnostics were major depression (26.4%) and bipolar disorder (11.1%).

Conclusion

A high prevalence of mental disorders was observed, especially major depression and bipolar disorder. The data obtained regarding the relationship between PCOS and mood disorders in a Brazilian sample is in accordance with recent research findings in the same area.     

Prevalence of psychiatric disorders in patients with diabetes types 1 and 2

Background

Diabetes mellitus, classified into types 1 and 2, is a chronic disease that shows high comorbidity with psychiatric disorders. Insulin-dependent patients show a higher prevalence of psychiatric disorders than do patients with type 2 diabetes.

Methods

This research involved the participation of 200 subjects divided into 2 groups: 100 patients with diabetes type 1 and 100 patients with diabetes type 2. This study used the Mini International Neuropsychiatric Interview for the identification of psychiatric disorders.

Results

Of the 200 participants, 85 (42.5%) were found to have at least 1 psychiatric disorder. The most prevalent disorders were generalized anxiety disorder (21%), dysthymia (15%), social phobia (7%), current depression (5.5%), lifelong depression (3.5%), panic disorder (2.5%), and risk of suicide (2%). Other disorders with lower prevalence were also identified. The groups showed a statistically significant difference in the presence of dysthymia, current depression, and panic disorder, which were more prevalent in patients with diabetes type 1.

Conclusion

The high prevalence of psychiatric disorders in diabetic patients points to the need for greater investment in appropriate diagnostic evaluation of patients that considers mental issues. The difference identified between the groups shows that preventive measures and therapeutic projects should consider the specific demands of each type of diabetes.     

Autoantibodies associated with psychiatric disorders

Growing evidence suggests that autoantibodies to neuronal or endothelial targets in psychiatric disorders exist and may be pathogenic. This review describes and discusses the possible role of autoantibodies related to the psychiatric manifestations in autoimmune diseases, autoantibodies related to the psychiatric disorders present in post-streptococcal diseases, celiac disease, chronic fatigue syndrome and substance abuse, and autoantibodies related to schizophrenia and autism, disorders now considered of autoimmune origin.     

Dementia associated with psychiatric disorders

Functional psychiatric disorders are associated with a variety of cognitive deficits and, in some instances, severe cognitive impairment. This paper reviews the cognitive profile of patients with schizophrenia, depression, bipolar and anxiety disorders, as well as the longitudinal course and clinical outcome of the cognitive impairment associated with these conditions. The paper also discusses some of the mechanisms that may contribute to the expression of the cognitive deficits in these disorders and their potential relationship with common causes of dementia.