Luo Hongye, McNeil Edward B, Feng Qiming, Li Hongheng, Chen Qiang, Qin Xianjing, Feng Jun, Assanangkornchai Sawitri
1Information and Management School, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region China.
2Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Thailand.
Int J Ment Health Syst. 2018 Apr 17;12:17. doi: 10.1186/s13033-018-0197-z. eCollection 2018.
To identify the rate and predictors of utilization of rehabilitation services among people with psychotic disorders in rural communities of Guangxi.
A cross-sectional survey was conducted among individuals with schizophrenia or other psychoses (severe mental disorder, ICD10: F20-F29), aged over 15 years, and their care-givers in Guangxi, China. Trained village doctors located individuals known to them and suspected as having schizophrenia or other psychoses within the target areas and recruited them into the study. Data on demographic characteristics, clinical symptoms and functions, treatment history, and reasons, if any, for non-utilization of mental health service were collected. Logistic regression was used to determine associated factors for utilization of mental health services.
A total of 424 individuals experiencing psychosis (mean age 41.4 ± 13.0 years, 60.6% male) and 319 caregivers (mean age 55.3 ± 14.2 years) were interviewed. The median duration of disease was 13.4 years. 83.0% of patients had never used rehabilitation services. Greater use of rehabilitation was associated with having a non-organic disorder (OR = 11.6, 95% CI = 1.6-86.0) and living with a caregivers (OR = 3.2, 95% CI = 1.2-8.3). The top three reasons for not using rehabilitation services were lack of awareness (57.1%), lack of money (14.2%) and lack of belief in the service (12.8%).
These findings indicate a high unmet need for psychiatric rehabilitation services among people with psychotic disorders in rural areas of Guangxi. Strategies such as outreach programme and collaborative and partnership network with the local community are needed to encourage people with psychotic disorders in rural communities to increase their utilization of rehabilitation services.
确定广西农村社区精神障碍患者康复服务的利用率及其预测因素。
对中国广西年龄在15岁以上的精神分裂症或其他精神病患者（严重精神障碍，ICD10：F20 - F29）及其照顾者进行横断面调查。经过培训的乡村医生在目标区域内找出他们认识且怀疑患有精神分裂症或其他精神病的个体，并将其纳入研究。收集了有关人口统计学特征、临床症状与功能、治疗史以及未使用心理健康服务的原因（如有）等数据。采用逻辑回归分析来确定心理健康服务利用的相关因素。
共访谈了424名精神病患者（平均年龄41.4±13.0岁，男性占60.6%）和319名照顾者（平均年龄55.3±14.2岁）。疾病的中位病程为13.4年。83.0%的患者从未使用过康复服务。康复服务利用率较高与非器质性障碍（OR = 11.6，95%CI = 1.6 - 86.0）以及与照顾者同住（OR = 3.2，95%CI = 1.2 - 8.3）有关。未使用康复服务的三大主要原因是缺乏认识（57.1%）、缺钱（14.2%）和对服务缺乏信任（12.8%）。
这些研究结果表明，广西农村地区精神障碍患者对精神康复服务的需求远未得到满足。需要开展外展项目以及与当地社区建立合作与伙伴关系网络等策略，以鼓励农村社区的精神障碍患者提高康复服务的利用率。
