精神科门诊不同时点病例资料对比分析

目的探讨不同时点精神科门诊就诊结构及治疗状况。方法抽取2006年1月1日～2月10日在我院门诊就诊的480例精神病患者设为研究组，抽取2001年1月1日～2月10日在我院门诊就诊的404例精神病患者设为对照组。统计两组患者的一般资料、疾病诊断及药物治疗状况并进行对比分析。结果两组一般资料均无显著性差异（P〉0．05）；研究组情感性精神病、疑似精神分裂症诊断率显著高于对照组，而分裂样精神病诊断率显著低于对照组（P均〈0．01）；抗精神病药物奋乃静、舒必利选择率显著低于对照组，而阿立哌唑、喹硫平选择率显著高于对照组（P〈0．01）；抗抑郁剂曲唑酮、氟西汀选择率显著低于对照组，而舍曲林、帕罗西汀、西酞普兰选择率显著高于对照组（P〈0．05或0．01）；情绪稳定剂丙戊酸钠选择率显著高于对照组（P〈0．01）；苯二氮革类药物氯硝西泮选择率显著低于对照组（P〈0．01）。结论精神科门诊就诊者情感性精神病及疑似精神分裂症诊断率显著增加，而分裂样精神病诊断率显著下降；新型抗精神病药物及新型抗抑郁剂使用率有明显增加趋势；苯二氮革类药物使用率有显著下降趋势。首诊病程尚无变化，人们对精神疾病的认识依然不足，有关职能部门应进一步加大宣传力度，提高人们对精神疾病的认识能力，以利于早发现、早就医。

Contrastive analyses of medical history of psychiatry outpatient service at different time-points

Objective To explore the structure of doctors' office visiting and therapeutic status at psychiatry outpatient service at different time-points. Methods 480 patients with psychosis who visited doctors' office at outpatient service of our hospital from Jan. 1 to Feb. 10, 2006 were assigned to research group and 404 ones from Jan. 1 to Feb. 10, 2001 to control group.General data,disease diagnosis and medication status were added up and analyzed contrastively. Results There were no significant differences in general data(P>0.05);diagnostic rates of affective psychoses and suspected schizophrenia were significantly higher and that of schizophreniform psychosis lower in the research group(all P<0.01);selective rates of antipsychotics such as perphenazine and sulpiride were significantly lower and those of aripiprazole and quetiapine higher in the research group(P<0.01); those of antidepressants such as trazodone and fluoxetine were significantly lower and those of sertraline,paroxetine and citalopram higher in the research group(P<0.05 or 0.01); that of mood stabilizer as sodium valproate was significantly higher in the research group(P<0.01); that of benzodiazepines as clonazepam was significantly lower in the research group(P<0.01). Conclusion Diagnostic rates of affective psychoses and suspected schizophrenia obviously increase in psychiatric out-patients and that of schizophreniform psychosis decrease;utilizations of novel antipsychotics and antidepressants have obvious increasing tendency and those of benzodiazepines decrease significantly. First-diagnostic course has no changes and persons' knowledge regarding psychosis is still insufficient,relevant functional departments should further increase propaganda vigor and raise persons' perceptual ability to psychoses to be good for early recognition and receiving medical treatment in time.