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[多次入住精神病院——对所谓“旋转门患者”状况的一项研究]

[Multiple admissions to the psychiatric hospital--a study of the status of so-called "revolving door patients"].

作者信息

Hofmann W, Gougleris G, Panzer M, Tigiser E, Warken R, Zimmer F P

机构信息

Klinik Sonnenberg, Saarbrücken.

出版信息

Psychiatr Prax. 1992 Nov;19(6):217-24.

PMID:1480673
Abstract

The graph of the frequency distribution of rehospitalization shows a constant exponential decline without demarking a particular population of so-called "revolving-door" patients. Patients with at least four admissions to a regional psychiatry hospital within a time span of two years are compared to a control group of the total clinic population. Multiple admission patients suffer significantly more often from diseases with an unfavourable prognosis, the illness has started earlier in their lives, and the course of illness is marked by unstable dynamic states with frequent crises of suicide. A demographic analysis shows the group under survey to be younger and less often married; participation in the world of labour has been lost more often, schizophrenics who have frequently stayed in hospitals even loose their former autonomy in housing. Guardianships are significantly more often installed, but they have not proved to be an efficient form of help. The therapeutic care of this problem patients is rather unsatisfactory. The offered ambulatory services are not claimed and in hospital the special treatment units fail to reach these patients. Lack of therapeutic continuity and compliance determines the course of treatment and complicates therapeutic strategies.

摘要

再住院频率分布图表显示出持续的指数下降趋势,并未区分出所谓的“旋转门”患者这一特定群体。将在两年时间内至少四次入住某地区精神病医院的患者与整个诊所人群的对照组进行比较。多次入院患者更常患有预后不良的疾病,疾病在他们生命中开始得更早,病程以不稳定的动态状态为特征,伴有频繁的自杀危机。人口统计学分析表明,受调查群体更年轻,结婚率更低;他们更常失去劳动参与度,频繁住院的精神分裂症患者甚至在住房方面失去了以前的自主性。监护安排明显更为常见,但尚未证明其是一种有效的帮助形式。对这些问题患者的治疗护理相当不尽人意。所提供的门诊服务无人使用,而在医院里,特殊治疗单元也未能接触到这些患者。缺乏治疗连续性和依从性决定了治疗进程,并使治疗策略复杂化。

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