住院老年精神疾病患者的现状调查

目的:对住院老年精神疾病患者的现状进行调查。方法:采用回顾性调查法和整群抽样法,收集四川省5所精神专科医院2013年5月至2013年10月住院的所有老年精神疾病患者的病历记录及一般人口学资料进行统计分析。结果:870例有效数据中,老年精神疾病患病率前3位依次为精神分裂症、器质性精神障碍及抑郁症;男性和女性的抑郁症、物质所致精神障碍、神经症的患病率差异有统计学意义(χ~2=41.142,P0.05);农村与城市在精神分裂症、器质性精神病、躁狂症、神经症及双相障碍的患病率分布差异有统计学意义(χ~2=78.435,P0.05)。Logistic回归分析显示,年龄(OR=1.037,P=0.001)和治疗方式(OR=0.252,P=0.000)对疗效影响显著。结论:住院老年精神疾病患者以农村、女性老人为多;综合治疗效果优于单纯药物治疗。     

心内科老年住院患者跌倒原因及对策

跌倒是住院患者常发生的意外事件,心血管疾病是引起患者跌倒的主要原因.影响脑血流灌注及氧供应的心血管疾病,如心律失常性晕厥、充血性心力衰竭、心肌纤颤、血压过高、糖尿病患者低血糖、症状性低血压等均可导致患者头晕,体力不支而跌倒[1].跌倒易造成骨折、软组织甚至脏器的损伤,限制了患者的活动范围,导致严重的心理或社会障碍.因此,总结分析导致心血管老年住院患者跌倒的原因,有针对性地加强安全管理措施和宣传教育,能有效降低患者跌倒的潜在风险,提高护理安全.     

老年精神障碍患者跌倒预防的研究进展

跌倒是常见的医院不良事件,患有精神障碍的老年患者跌倒风险增加,一般的危险因素包括认知障碍、痴呆、抑郁状态、焦虑状态、谵妄状态、服用抗精神病药物、电休克治疗、合并躯体疾病、给药过多、睡眠障碍等。相关的精神科疾病有阿尔茨海默病、抑郁症、焦虑症等。常见的预防措施有功能训练、认知－运动训练、多感官治疗、药物管理、员工培训等。现在越来越多的学者认为多因素风险评估与针对性的多元化干预措施是预防老年精神障碍患者跌倒的关键。     

住院精神疾病患者自杀调查

对我院建院以来自杀身亡的病例进行调查分析1　一般资料1975～ 2 0 0 1年期间 ,我院共收治精神疾病患者 2 2 917例次 ,自杀身亡者 15例。其中男 9例 ,女 6例。年龄 2 2～ 49岁 ,平均 31 7岁 ,其中 2 2～ 39岁 12例。文盲 1例 ,小学 3例 ,中学 10例 ,大学 1例。已婚 6例 ,未婚 9例。2　临床分析诊断为精神分裂症 12例 ,精神分裂症后抑郁 1例 ,抑郁症 2例。伴有躯体疾病 2例。均无精神疾病家族史。住院前有轻生意念或自杀行为者 4例。自杀由精神病性症状 (幻觉、妄想 )所致 9例 ,由抑郁、自责所致 4例 ,由生活事件、心理负担所致 2例。自杀方…     

住院精神疾病患者骨折调查

我们对住院精神疾病患者发生骨折的情况进行回顾性调查,报告如下. 1 对象和方法 为我院2002年至2007年期间住院精神疾病患者,均服用抗精神病药,共385例,发生骨折者22例,占5.17%.对有关资料进行统计分析.     

对精神疾病患者就诊途径的调查

作者对精神疾病患者就诊途径进行了调查 ,现报告于后。1　对象与方法1.1　调查对象　为 1999年 8月～ 2 0 0 0年 8月首次入院的精神疾病患者 ,共计 2 6 0例。其中 ,男 15 8例 ,女 10 2例 ,平均年龄 (34 .7± 10 .9)岁 ,大专以上文化 16例 ,中专 19例 ,高中 78例 ,初中 81例 ,小学以下 6 6例 ,城市 172例 ,农村 88例 ,平均病程 (85 .4± 41.7)天。诊断为精神分裂症 12 5例、分裂样精神病 9例、偏执性精神病 3例、情感性精神障碍 38例、酒精所致精神障碍 9例、颅脑创伤所致精神障碍 8例、癫疒间 所致精神障碍 10例、阿尔茨海默病 3例、气功所…     

精神疾病患者的婚姻和生育状况调查

对１４５７例精神疾病患者进行了婚姻及生育状况调查，并以正常人群作比较。结果发现，精神疾病患者成婚率低，生育能力与正常人相同，子代患病率高，家庭和睦程度及经济状况均低于正常人。提出了对精神疾病患者应控制生育，以及对计划生育队伍进行精神卫生知识的普及培训等对策。     

精神疾病患者弓形虫感染调查

对我院住院的精神疾病患者进行血清弓形虫抗体的检测 ,报告如下。1　对象和方法以我院所有住院的精神疾病患者为检测对象 ,共 4 5 5例。以本地正常人群 5 0 0名为对照。由我院化验室采集滤纸片标本 ,杭州市三佳生物技术有限公司检测。采用间接凝集法初验 ,凡滴定度在 1∶6 4以上的再用全标法复验 ,复检阳性即为血清弓形虫抗体阳性。2　结果本组患者弓形虫抗体阳性率 14 1% (6 4 /45 5 ) ,显著较对照组 1 8% (9/5 0 0 )为高 (P <0 0 1)。其中精神分裂症弓形虫抗体阳性率 17 3% (5 1/2 95 ) ,抑郁症 11 4 % (5 /44 ) ,躁狂症9 7% (3/31) ,…     

中山市老年精神疾病流行病学调查

目的：了解中山市老年精神疾病流行病学情况。方法：采用1982年和1993年2次全国精神疾病流行学调查使用的方法。结果：中山市老年精神疾病（不含精神症）终生患病率47.62%，显著高于一般人口（≥15岁）。结论：随着人口的老龄化，老年精神疾病应列为防治和研究的重点。     

住院精神疾病患者药物治疗临床分析

目的:分析目前住院精神疾病患者所接受的药物治疗是否规范.方法:采用自行设计的问卷,调查湖南省7所精神病院住院病人658例用药情况.结果:62.6%的病人为单一用药.精神分裂症治疗最常用药物是氯氮平(41.9%),最常用的联合用药为氯氮平 舒必利;情感障碍治疗最常用药物是碳酸锂(41.8%),最常用的联合用药是碳酸锂 氯氮平.结论:多数精神病院的住院病人的用药是规范的,但也存在不合理用药的现象.     

精神障碍住院患者出院后1年内再住院的危险因素

目的 探讨精神科住院患者出院后1年内再住院的危险因素,为临床评估及干预提供参考.方法 通过电子病历系统,收集2013年-2017年在广州医科大学附属脑科医院住院患者的信息.对患者再入院的危险因素进行生存分析,使用COX风险回归并绘制生存曲线,使用多元线性回归对患者出院后1年内至再次入院的间隔天数的影响因素进行分析.结果...     

Multivariate prediction of falls in elderly inpatients

One hundred and forty falls sustained by 65 psychogeriatric inpatients of average age 77.1 were studied in an attempt to identify risk factors. Multivariate analysis revealed increased age, a diagnosis of dementia and use of tricyclic antidepressants to be positively associated with falls when comparison was made to a control group of patients treated on the same unit who did not fall. Use of high-potency neuroleptics was negatively associated with falls in the same analysis. A second analysis failed to reveal any variables, including routine daily measurements of orthostatic change in blood pressure, to be associated with rate of falling within the group of fallers.     

Violence among psychogeriatric inpatients with dementia

The characteristics of all patients with dementia admitted to an acute psychogeriatric admission ward over a 36-month period were examined. Patients with dementia who had been responsible for acts of violence were compared with those with dementia who had not. Violent patients were more likely to have an ICD-9 diagnosis of senile dementia. Levels of violence were low, with only a small number of patients exhibiting violent behaviour. The implications of these findings for evaluative studies of pharmacotherapy and staff training in aggression control techniques are discussed.     

Association between sleep disturbances and falls among the elderly: results from the German Cooperative Health Research in the Region of Augsburg-Age study

ObjectiveWe aimed to examine the association between various sleep disturbances and falls among older individuals from the general population while considering the influence of age and dizziness.MethodsData were derived from the population-based cross-sectional KORA (Cooperative Health Research in the Region of Augsburg)-Age study, whereby information was conducted in standardized telephone interviews with 4127 men and women aged ⩾65 years in 2008 and 2009. Unstratified and stratified (by age and dizziness) multivariable logistic regression model analyses were performed.ResultsThe multivariable analysis showed a marginally significant association between trouble staying asleep and ⩾1 fall in the previous year (odds ratio [OR], 1.23 [95% confidence interval (CI), 1.01–1.50]). This association was more pronounced in participants older than the age of 75 years (OR, 1.58 [95% CI, 1.16–2.16]) and in individuals without dizziness (OR, 1.35 [95% CI, 1.04–1.76]). There was no association between daytime sleepiness and falls in the fully-adjusted models, but the odds of falls in the previous year in individuals older than the age of 75 years were significantly higher for individuals with difficulty falling asleep. Although sleep duration was not associated with falls in multivariable analyses when stratified by dizziness, sleep duration of 9 h daily was significantly associated with higher odds of experiencing at least one fall in the previous year.ConclusionsOur study suggested that the positive relationship between a trend towards longer sleep duration, trouble falling and staying asleep, and falls is strongest in older individuals and in individuals who did not experience dizziness in the previous year.     

Risk factors for readmission among a cohort of psychiatric inpatients in Lilongwe,Malawi

Abstract

Objectives: Inpatient psychiatric capacity is limited in Malawi and no published studies have assessed psychiatric readmissions there. Information about factors associated with readmission may help guide strategies to reduce readmission rates and keep patients stabilised in the community. Our goal was to determine factors associated with readmission among a cohort of psychiatric inpatients in Lilongwe, Malawi.

Methods: We conducted a retrospective chart review of all patients admitted to an inpatient psychiatric unit in Lilongwe, Malawi from January 1 to December 31, 2011. We used logistic regression to test for associations between readmissions during the study period and patient variables.

Results: 419 patients were hospitalised during the study period. Twenty-nine patients (6.9%) were readmitted at least once during the study period. Readmission was associated only with intentional medication non-adherence at home (aOR: 3.33, p?=?0.02).

Conclusions: Intentional medication non-adherence is a potentially modifiable behaviour associated with psychiatric readmission. Efforts to improve medication adherence among patients following hospital discharge may help decrease the risk of readmission.

• KEY POINTS

• The prevalence of readmission among psychiatric inpatients in Lilongwe, Malawi was 6.9% during the 1-year study period.

• Readmission was associated with intentional medication non-adherence at home.

• Future research efforts in Malawi should focus on improving medication adherence among psychiatric patients in the community to help decrease rates of readmission.

     

Prevalence and identification of alcohol use disorders among severe mental illness inpatients in Taiwan

Aims:  A higher prevalence of alcohol use disorders (AUD) among psychiatric patients has been reported previously and the identification rate is relatively low. This study was designed to investigate the prevalence and identification of AUD among acute psychiatric inpatients with severe mental illness in a psychiatric hospital in Taiwan.
Methods:  In a two-phase case identification strategy, the Alcohol Use Disorders Identification Test (AUDIT) was used as the first phase screening tool and the Structured Clinical Interview for DSM-IV-TR as the second phase diagnostic interview. The definition of identification was diagnosis of AUD on medical record at discharge.
Results:  Of 400 respondents, 42 screened positive and 358 screened negative. All screen-positive respondents and 35 screen-negative respondents entered the second phase interview. The weighted lifetime prevalence of alcohol dependence was 8.3% (95% confidence interval [CI]: 4.6–11.9%); alcohol abuse, 1.5% (95%CI: 0.2–2.8%); and AUD, 9.8% (95%CI: 5.7–13.8%). The overall identification rate of AUD by medical staff was 28.2% (0% for alcohol abuse and 33.3% for alcohol dependence). Patients with mood disorders were prone to being undetected as having AUD.
Conclusion:  AUD comorbidity was common among inpatients with severe mental illness in Taiwan and was easily neglected by medical staff. It is necessary to use a validated screening questionnaire, such as AUDIT, to detect high-risk patients and then give appropriate interventions to enhance treatment outcome.     

抑郁症住院患者适应性睡眠改变的研究

目的　了解抑郁症住院患者适应性睡眠改变的情况。方法　连续两晚测量 14例抑郁症住院患者的多导睡眠图 ,比较其两晚的睡眠参数。结果　患者的睡眠总时间、睡眠潜伏期、醒起时间、运动觉醒时间、醒觉次数、睡眠效率、睡眠结构、快动眼 (REM)睡眠潜伏期、REM强度、REM密度、REM时间、REM周期数等指标 ,第 1晚与第 2晚的差异均无显著性 (P均 >0 0 5 )。结论　抑郁症住院患者存在适应性睡眠改变的相对缺乏 ,其第 1晚的睡眠资料不应轻易地丢弃。