青海省藏族精神分裂症未治期及影响因素分析

目的探讨藏族精神分裂症患者精神病未治期(duration of untreated psychosis,DUP)的影响因素。方法采用精神分裂症患者精神卫生服务利用调查问卷及精神分裂症首发症状评定量表对188例藏族精神分裂症患者的社会人口学资料、精神疾病家族史、家庭类型、起病形式、医疗付款方式、居住地、自评家庭收入水平、首发症状出现的时间等进行调查,分析DUP影响因素。结果患者DUP呈偏态分布,中位数375 d(QL=4 d,QU=1661 d)。将患者分为短DUP组(DUP≤375 d)90例和长DUP组(DUP375 d)98例,不同DUP组患者的起病形式、婚姻状况、文化程度、家庭类型、居住地的组间差异有统计学意义(P0.05)。DUP影响因素的logistic回归分析显示,结构缺失的家庭(OR=2.340,95%CI:1.130~4.847,P=0.022)、慢性起病(OR=2.136,95%CI:1.172~3.891,P=0.013)、居住在农牧区(OR=2.239,95%CI:1.097~4.571,P=0.027)与长DUP相关联。结论藏族精神分裂症DUP较长,受多种因素影响,主要的危险因素有结构缺失的家庭、慢性起病、居住在农牧区。

Duration of untreated psychosis and the related factors among Tibetan patients with schizophrenia in Qing- hai

Objective To study related factors of the duration of untreated psychosis (DUP) in Tibetan patients with schizophrenia in Qinghai Province. Methods The related factors on DUP were investigated in totally 188 Tibetan pa?tients with schizophrenia using questionnaires of mental health services and symptom onset for schizophrenia. All the Ti?betan patients were provided with the National Continuing Management and Intervention Program for Psychoses (686 Pro?gram). Results The median (low quartile, upper quartile) of DUP in Tibetan patients with schizophrenia was 375 days (4 days, 1661 days). The patients were divided into short DUP group (DUP≤375days, 90 patients) and long DUP group (DUP>375 days, 98 patients). There were significant differences in mode of onset,marital status, educational level, family type, place of residence between short DUP group and long DUP group (P<0.05). Logistic regression analysis found that lack of family structure (OR=2.340, 95%CI:1.130~4.847, P=0.022), chronic onset (OR=2.136, 95%CI:1.172~3.891, P=0.013) and living in pastoral areas (OR=2.239, 95%CI:1.097~4.571, P=0.027) were risk factors of DUP. Conclusion Ti?betan patients with schizophrenia have a longer DUP and related risk factories of DUP are lack of family structure, chron?ic onset and living in pastoral areas.