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严重精神疾病患者的医学共病情况:对卡塔尔一家门诊诊所精神科患者的回顾性研究

Medical comorbidities in patients with serious mental illness: a retrospective study of mental health patients attending an outpatient clinic in Qatar.

作者信息

Zolezzi Monica, Abdulrhim Sara, Isleem Nour, Zahrah Farah, Eltorki Yassin

机构信息

Clinical Pharmacy and Practice.

College of Pharmacy, Qatar University.

出版信息

Neuropsychiatr Dis Treat. 2017 Sep 15;13:2411-2418. doi: 10.2147/NDT.S141448. eCollection 2017.

Abstract

BACKGROUND

The life span of individuals with serious mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. The aim of the study was to investigate the prevalence rates of different physical illnesses in individuals with SMI and to examine how these are being managed.

METHODS

The study was a cross-sectional retrospective chart review of a cohort of patients with SMI. A comprehensive electronic data extraction tool using SurveyMonkey was used to collect patient demographics, psychiatric and medical comorbidities, medications and all relevant physical assessments. Data were then first extrapolated into an Excel spreadsheet and later to SPSS for data analysis. A descriptive statistical approach was used to analyze the demographic and clinical data. Chi-square test for categorical variables and -test for continuous variables were used to compare the demographic and clinical characteristics of the cohort.

RESULTS

A total of 336 patients with SMI were included for the retrospective chart review. The majority of these patients had a diagnosis of depression (50.3%), followed by schizophrenia (33.0%) and bipolar disorder (19.6%). Diabetes was the most frequent medical comorbidity, diagnosed in 16.1% of SMI patients, followed by hypertension (9.2%) and dyslipidemia (9.8%). Monitoring of comorbidity-associated risk factors and other relevant physical assessment parameters (such as blood pressure, weight, hemoglobin A1c [HbA1c], blood glucose and lipids) were documented in less than 50% of patients, and some parameters, such as smoking status, were not documented at all.

CONCLUSION

Both, the literature and our cohort provide evidence that individuals with SMI are less likely to receive standard levels of care for their medical comorbidities.

摘要

背景

与普通人群相比,严重精神疾病(SMI)患者的寿命较短。这种额外的死亡率主要归因于躯体疾病。本研究的目的是调查SMI患者中不同躯体疾病的患病率,并检查这些疾病的管理情况。

方法

本研究是对一组SMI患者进行的横断面回顾性病历审查。使用SurveyMonkey的综合电子数据提取工具收集患者的人口统计学信息、精神和躯体合并症、用药情况以及所有相关的躯体评估。数据首先被外推到Excel电子表格中,随后导入SPSS进行数据分析。采用描述性统计方法分析人口统计学和临床数据。使用卡方检验分析分类变量,使用t检验分析连续变量,以比较该队列的人口统计学和临床特征。

结果

共有336例SMI患者纳入回顾性病历审查。这些患者中大多数被诊断为抑郁症(50.3%),其次是精神分裂症(33.0%)和双相情感障碍(19.6%)。糖尿病是最常见的躯体合并症,在16.1%的SMI患者中被诊断出,其次是高血压(9.2%)和血脂异常(9.8%)。不到50%的患者记录了合并症相关危险因素和其他相关躯体评估参数(如血压、体重、糖化血红蛋白[HbA1c]、血糖和血脂),一些参数,如吸烟状况,根本没有记录。

结论

文献和我们的队列均提供了证据,表明SMI患者不太可能获得针对其躯体合并症的标准护理水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6e9/5608084/cf5d780d7dbd/ndt-13-2411Fig1.jpg

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