Zhou Jian-Song, Xiang Yu-Tao, Zhu Xiao-Min, Liang Weiye, Li Haien, Yi Jialong, Liu Fei, Zhao Na, Chen Gang, Shi Shulin, Li Guoping, Shen Danlin, Wei Ning, Qi Fang, Tan Wei, Ungvari Gabor S, Ng Chee H, Hao Wei, Li Lingjiang, Wang Xiaoping
Dr. Zhou, Dr. Zhu, Dr. Hao, Dr. Lingjiang Li, and Dr. Wang are with Hunan Province Technology Institute of Psychiatry and Key Laboratory of Psychiatry and Mental Health of Hunan Province, Second Xiangya Hospital, Central South University, Changsha, China (e-mail:
Psychiatr Serv. 2015 Dec 1;66(12):1341-6. doi: 10.1176/appi.ps.201400566. Epub 2015 Sep 1.
This study examined admission patterns, including voluntary, involuntary, and partly voluntary admissions to Chinese psychiatric hospitals, in relation to sociodemographic and clinical factors, before a new mental health law was implemented in 2013.
Previously admitted patients were interviewed within one week after discharge from 16 psychiatric hospitals across China. Patients' basic sociodemographic and clinical data, including results from the Modified Overt Aggression Scale (MOAS) and the Insight and Treatment Attitudes Questionnaire (ITAQ), were collected.
Among 797 patients, 224 (28%) had voluntary admissions, 336 (42%) had involuntary admissions, and 237 (30%) had partly voluntary admissions. Male gender, history of hospitalization, diagnosis of schizophrenia and related disorders, and high MOAS score were the risk factors for involuntary admissions, whereas more years of education, higher ITAQ score, and outpatient treatment before the index admission were its protective factors. A diagnosis of schizophrenia-related disorder and high MOAS score were the risk factors for partly voluntary admission, whereas more education and high ITAQ score were its protective factors.
Perception of dangerousness and poor insight about mental illness were significant factors in involuntary psychiatric admissions in China. Factors contributing to the changes in patterns of psychiatric admissions after China's implementation of the mental health law are important topics for further research.
本研究调查了2013年新的精神卫生法实施之前，中国精神病医院的入院模式，包括自愿、非自愿和部分自愿入院情况，并分析其与社会人口统计学和临床因素的关系。
对中国16家精神病医院此前收治的患者在出院后一周内进行访谈。收集患者的基本社会人口统计学和临床数据，包括修订版外显攻击行为量表（MOAS）和自知力与治疗态度问卷（ITAQ）的结果。
797例患者中，224例（28%）为自愿入院，336例（42%）为非自愿入院，237例（30%）为部分自愿入院。男性、住院史、精神分裂症及相关障碍诊断、MOAS高分是非自愿入院的危险因素，而受教育年限更长、ITAQ得分更高、本次入院前接受门诊治疗是非自愿入院的保护因素。精神分裂症相关障碍诊断和MOAS高分是部分自愿入院的危险因素，而受教育程度更高和ITAQ得分高是其保护因素。
对危险性的认知和对精神疾病的自知力差是中国非自愿精神科入院的重要因素。中国实施精神卫生法后精神科入院模式变化的影响因素是进一步研究的重要课题。
