Holloway F, Wykes T, Petch E, Lewis-Cole K
Maudsley Hospital, Denmark Hill, London.
Int J Soc Psychiatry. 1999 Summer;45(2):93-103. doi: 10.1177/002076409904500202.
We assessed the long-stay inpatients (length of stay > 6 months) from a deprived inner-city catchment area with a population of 210,000 in 1993 and 1995 on a variety of measures, following up both cohorts after 24 months. Total numbers of long-stay inpatients were reduced from 56 (26.7 per 100,000 total population) to 35 (16.7 per 100,000) between 1993 and 1995, in line with the closure of dedicated long-stay beds. The 1995 cohort were more symptomatic according to the BPRS (t = 2.8, p = 0.007, 95% confidence interval 18.1, 3.0), more commonly detained under the Mental Health Act (chi 2 = 6.07 p = 0.05) and more commonly from an ethnic minority (chi 2 = 3.7 p = 0.05). At 2 year follow-up 57% of the 1993 cohort were living out of hospital, compared with 60% of the 1995 cohort. Patients were discharged to a variety of settings, some highly supported. For the combined sample the presence of certain challenging behaviours (absconding, disturbance at night, noncompliance with treatment and violence) predicted continuing inpatient status as did three items on the Social Behaviour Schedule (bizarre behaviour, laughing to oneself and violence). Only five (9%) of the original sample remained inpatients for the entire four year follow-up.
我们对来自市中心贫困集水区的长期住院患者（住院时间>6个月）进行了评估，该集水区在1993年和1995年的人口为21万，采用了多种测量方法，并在24个月后对两个队列进行了随访。1993年至1995年间，长期住院患者总数从56人（每10万总人口中26.7人）降至35人（每10万人口中16.7人），这与专用长期住院床位的关闭相一致。根据简明精神病评定量表（BPRS），1995年队列的症状更明显（t=2.8，p=0.007，95%置信区间18.1,3.0），根据《精神健康法》被拘留的情况更常见（卡方=6.07，p=0.05），且来自少数民族的情况更常见（卡方=3.7，p=0.05）。在2年随访时，1993年队列中有57%的患者出院，而1995年队列中这一比例为60%。患者被 discharged 到各种环境中，有些得到了高度支持。对于合并样本，某些具有挑战性的行为（潜逃、夜间干扰、不遵守治疗和暴力）的存在以及社会行为量表上的三个项目（怪异行为、独自发笑和暴力）预测了持续住院状态。在整个四年随访中，原始样本中只有五人（9%）仍为住院患者。
