精神障碍者的自知力与自愿入院和自愿治疗的关系

目的 探讨精神障碍者的自知力与入院态度和治疗态度的关系，以及影响入院态度的相关因素。方法 对符合纳入标准的313例精神障碍者于入院时、出院时评定入院态度、治疗态度、自知力、BPRS或BRMS、HAMD各量表总分、因子分。结果 1．本研究中精神障碍者自愿入院率为37．0％，非正规入院率40．3％，强迫入院率22．7％；治疗态度中自愿治疗的占42．2％，治疗不治疗都可以的占17．9％，坚决拒绝治疗的占39．9％。自知力与入院态度和治疗态度明显相关，自知力是影响入院态度的主要因素。结论 目前，我国精神卫生立法适宜于采取自愿入院、非正规入院、强迫入院三种入院形式；本研究为我国精神卫生立法有关条款的制定提供了事实依据。

A study of insight in relation to voluntary admission and voluntary treatment of persons with mental disorders

Objective To study the relationship of mental patients' insight with admission attitude and treatment attitude ;To identify the influential factors to their admission attitude. Methods 313 patients, who met our inclusion criteria, were assessed in aspect of admission attitude, treatment attitude, insight, and illness severity with symptom rating scales such as BPRS, BRMS, HAMD at the time of admission and discharge. Results In this study, voluntary admission rate was 37.0%, informal admission rate was 40.3%, compulsory admission rate was 22.7%. Percentage of patients who accept treatment voluntarily was 42.2%, acceptance of treatment passively 17.9%, refusal to treatment 39.9%. Insight was significantly correlated with admission attitude, and treatment attitude. Insight was the major factor affecting admission attitude. Conclusion Three admission models, voluntary admission, informal admission and compulsory admission, were suggested in legislation of mental health in China; this study provided some evidence for legislation of mental health related to admission and treatment principles for persons with mental disorders.