Grover Sandeep, Dua Devakshi, Chakrabarti Subho, Avasthi Ajit
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychiatry. 2018 Jan-Mar;60(1):49-55. doi: 10.4103/psychiatry.IndianJPsychiatry_410_17.
This study aimed to evaluate the "dropout" rates from treatment and associated factors among elderly patients attending a tertiary care psychiatry outpatient facility.
Data of 1422 patients aged ≥60 years, attending the walk-in clinic were evaluated.
Out of 1422 patients, 406 (28.55%) belonged to the "dropout" group. In the "dropout" group, the age of patients was significantly higher than the followed-up group, and a higher proportion of patients were >70 years old. Significantly lower proportion of patients with diagnosis of depressive disorders belonged to the "dropout" group and significantly higher proportion of patients with "other" diagnoses belonged to the dropped out group. In patients with depressive disorders, a higher proportion of the patients in the "dropout" group were Hindu by religion (68.7% vs. 58.7%; = 4.26; = 0.03). In patients with bipolar disorder, patients in the "dropout" group had significantly higher income (Rs. 13,323 [standard deviation [SD] = 16,769] vs. 5681 [SD = 9422]; -test value: 2-25; = 0.028) and lesser proportion of patients were of the male gender (63.15 vs. 86.95%; Mann-Whitney U value = 257.5; = 0.039). In the group of other diagnoses, a higher proportion of patients in the "dropout" group were currently single (32.3% vs. 18.7%; = 4.12; = 0.042), from rural locality (63.1% vs. 46.72%; = 4.33; = 0.037) and were not prescribed medications (40% vs. 22.4%; = 6.05; = 0.04).
Dropout from treatment among elderly patients is associated with higher age, not being prescribed medications, and diagnosis other than the affective disorders, psychotic disorders, and the cognitive disorders.
本研究旨在评估三级护理精神病门诊机构中老年患者的治疗“退出”率及相关因素。
对1422名年龄≥60岁、前来急诊门诊就诊的患者的数据进行评估。
在1422名患者中,406名(28.55%)属于“退出”组。在“退出”组中,患者年龄显著高于随访组,且70岁以上患者比例更高。诊断为抑郁症的患者中,属于“退出”组的比例显著更低,而诊断为“其他”疾病的患者中,属于退出组的比例显著更高。在患有抑郁症的患者中,“退出”组中印度教患者的比例更高(68.7%对58.7%;χ² = 4.26;P = 0.03)。在双相情感障碍患者中,“退出”组患者的收入显著更高(13323卢比[标准差[SD]=16769]对5681卢比[SD = 9422];t检验值:2.25;P = 0.028),男性患者比例更低(63.15%对86.95%;曼-惠特尼U值 = 257.5;P = 0.039)。在其他诊断组中,“退出”组中目前单身的患者比例更高(32.3%对18.7%;χ² = 4.12;P = 0.042),来自农村地区的患者比例更高(63.1%对46.72%;χ² = 4.33;P = 0.037),且未开具药物治疗的患者比例更高(40%对22.4%;χ² = 6.05;P = 0.04)。
老年患者治疗退出与年龄较大、未开具药物治疗以及非情感障碍、精神障碍和认知障碍的诊断有关。