精神分裂谱系障碍和双相情感障碍患者的身体健康行为和健康控制源：与非精神病性精神疾病患者的横断面比较研究。
Physical health behaviours and health locus of control in people with schizophrenia-spectrum disorder and bipolar disorder: a cross-sectional comparative study with people with non-psychotic mental illness.
机构信息
Department of Mental Health Sciences, University College London Medical School, London, UK.
出版信息
BMC Psychiatry. 2011 Jun 24;11:104. doi: 10.1186/1471-244X-11-104.
BACKGROUND
People with mental illness experience high levels of morbidity and mortality from physical disease compared to the general population. Our primary aim was to compare how people with severe mental illness (SMI; i.e. schizophrenia-spectrum disorders and bipolar disorder) and non-psychotic mental illness perceive their: (i) global physical health, (ii) barriers to improving physical health, (iii) physical health with respect to important aspects of life and (iv) motivation to change modifiable high-risk behaviours associated with coronary heart disease. A secondary aim was to determine health locus of control in these two groups of participants.
METHODS
People with SMI and non-psychotic mental illness were recruited from an out-patient adult mental health service in London. Cross-sectional comparison between the two groups was conducted by means of a self-completed questionnaire.
RESULTS
A total of 146 people participated in the study, 52 with SMI and 94 with non-psychotic mental illness. There was no statistical difference between the two groups with respect to the perception of global physical health. However, physical health was considered to be a less important priority in life by people with SMI (OR 0.5, 95% CI 0.2-0.9, p = 0.029). There was no difference between the two groups in their desire to change high risk behaviours. People with SMI are more likely to have a health locus of control determined by powerful others (p < 0.001) and chance (p = 0.006).
CONCLUSIONS
People with SMI appear to give less priority to their physical health needs. Health promotion for people with SMI should aim to raise awareness of modifiable high-risk lifestyle factors. Findings related to locus of control may provide a theoretical focus for clinical intervention in order to promote a much needed behavioural change in this marginalised group of people.
背景
与普通人群相比，精神疾病患者患有躯体疾病的发病率和死亡率都较高。我们的主要目的是比较患有严重精神疾病（SMI；即精神分裂症谱系障碍和双相情感障碍）和非精神病性精神疾病的人群如何感知他们的：（i）整体身体健康状况，（ii）改善身体健康的障碍，（iii）身体健康与生活重要方面的关系，以及（iv）改变与冠心病相关的可改变高危行为的动机。次要目的是确定这两组参与者的健康控制源。
方法
从伦敦一家成人精神卫生门诊服务机构招募了 SMI 和非精神病性精神疾病患者。通过自我完成的问卷对两组进行了横断面比较。
结果
共有 146 人参加了这项研究，其中 52 人患有 SMI，94 人患有非精神病性精神疾病。两组在整体身体健康感知方面没有统计学差异。然而，SMI 患者认为身体健康在生活中是一个不那么重要的优先事项（OR 0.5，95%CI 0.2-0.9，p = 0.029）。两组在改变高危行为的愿望方面没有差异。SMI 患者更有可能将健康控制源归因于他人（p < 0.001）和机会（p = 0.006）。
结论
SMI 患者似乎对自己的身体健康需求给予的优先级较低。针对 SMI 患者的健康促进应旨在提高对可改变的高危生活方式因素的认识。与控制源相关的发现可能为临床干预提供理论重点，以促进这一边缘化人群急需的行为改变。
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