甘肃省70538例居家重性精神疾病患者管理效果评价

目的掌握甘肃省重性精神疾病患者居家管理的干预现状,并对管理效果做出评价,为今后对重性精神疾病患者更好地进行社区康复管理、救治救助奠定基础。方法依据重性精神疾病管理治疗工作规范(2012年版)和国家基本公共卫生服务规范(2011年版),对甘肃省2015年1月至2016年4月期间,通过普查和线索调查筛查出疑似患者并确诊,然后进行随访,进一步收集和分析其接受随访管理(在管)、治疗、服药、危险行为发生情况等信息。结果甘肃省共计确诊重性精神疾病患者70538例,其中在管患者占81.08%(57195例)。在管、非在管和失访的重性精神疾病患者中,治疗率为69.92%(48009/68663),其中双相情感障碍的治疗率(76.00%)最高(均P0.001)。在管居家患者的服药率为42.16%(24113/57195),规律服药率为24.74%(14150/57195),其中偏执性精神病的服药率(51.98%)最高(均P0.001),癫痫所致精神障碍的规律服药率(31.02%)最高(均P0.001)。结论目前甘肃省重性精神疾病居家管理率、治疗率、在管居家患者的服药率和规律服药率均低于全国平均水平,在普及精神疾病防治知识和提高医务人员对重性精神疾病规范化治疗能力等方面需大力加强。

Study on the management and its effectiveness evaluation of 70538 patients with serious mental illness at home in Gansu province

Objective To analysis the family management of patients with serious mental illness in Gansu prov-ince, and evaluate its effectiveness to lay the foundation for the better community-based rehabilitation management and treatment for the people with serious mental illness. Method According to Treatment-management specification of severe mental illness (2012) and specification of national basic public health services (2011), the information such as home ther-apy, medicine taken, and dangerous behavior happened were collected from patients who were confirmed as serious men-tal illness in January 2015 to April 2016 in Gansu province. Result Up to April 30th, 2016, totally 70538 serious mental illnesses were identified, and about 81.10%(57195) were under management. The rate of treatment of serious mental ill-ness was 69.9%(48009/68663) in Gansu province, and Bipolar affective disorder (76.0%) was the highest (P<0.001). The rate of taking medication in patients under family-management was 42.16%(24113/57195), and the rate of taking regular medication was 24.74%(14150/57195). The rate of taking medication in Paranoiac psychosis patients (51.98%) was the highest (P<0.001), and the rate of taking regular medication in Mental disorders caused by epilepsy (31.02%) was the highest (P<0.001). Conclusion The rate of family-management, treatment, taking medication and take regular medica-tion of serious mental illness in Gansu province are all below the national average level. A special training should be giv-en to medical professionals to strengthen their capacity to treat serious mental illness.