Braam Arjan W, van Ommeren Omar W H R, van Buuren Melissa L, Laan Wijnand, Smeets Hugo M, Engelhard Iris M
Department of Emergency Psychiatry and Department of Specialist Training, Altrecht Mental Health Care, Utrecht, The Netherlands.
Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands; Palier Forensic Psychiatry, The Hague, The Netherlands.
J Emerg Med. 2016 Mar;50(3):449-57. doi: 10.1016/j.jemermed.2015.06.057. Epub 2015 Dec 21.
Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas.
The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density.
Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs. District characteristics included several demographic and economical factors and health care characteristics such as number of sheltered living facilities.
The AIPA density (mean 4.4/10,000 inhabitants/y) was four to five times higher in the most urbanized subdistrict (around 12) compared to the suburban subdistricts (2.5-3). On the district level, the main correlates with AIPA density per district were unemployment rate and small household size. Other correlates were percentage of non-Western immigrants and number of facilities of sheltered living.
The considerable AIPA density variation between subdistricts in this urban environment reflects that people who are prone to psychiatric admissions live in economically less prosperous environments. Impaired social networks and economic concerns may also contribute to an environment representing social defeat, increased demoralization, or social fragmentation.
急性非自愿精神科住院治疗（AIPA）在城市地区的应用往往更为频繁。
本研究旨在描述城市地区各分区之间AIPA患病率的差异，并确定哪些分区特征与较高的AIPA分区密度相关。
收集了荷兰乌得勒支市及其周边49个分区在64个月期间（2005 - 2010年）连续的AIPA信息，包括1098例AIPA病例。分区特征包括若干人口统计学和经济因素以及医疗保健特征，如庇护生活设施的数量。
与郊区分区（2.5 - 3）相比，城市化程度最高的分区的AIPA密度（平均4.4/10000居民/年）高出四到五倍（约为12）。在分区层面，与每个分区的AIPA密度主要相关的因素是失业率和家庭规模小。其他相关因素是非西方移民的百分比和庇护生活设施的数量。
在这个城市环境中，各分区之间AIPA密度存在显著差异，这反映出容易接受精神科住院治疗的人群生活在经济较不繁荣的环境中。受损的社会网络和经济问题也可能导致一种代表社会挫败、士气低落或社会分裂的环境。
