Yang Yuan, Li Wen, Lok Ka-In, Zhang Qinge, Hong Liu, Ungvari Gabor S, Bressington Daniel T, Cheung Teris, Xiang Yu-Tao
Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau; Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong, China.
Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau.
Asian J Psychiatr. 2020 Feb;48:101902. doi: 10.1016/j.ajp.2019.101902. Epub 2019 Dec 13.
Voluntary admission rates of schizophrenia vary widely across studies. In order to make the topic be informed by evidence, it is important to have accurate estimates. This meta-analysis examined the worldwide prevalence of voluntary admissions for patients with schizophrenia.
PubMed, EMBASE, PsycINFO, the Cochrane Library, Web of Science and Medline databases were systematically searched, from their commencement date until 19th November 2018. Meta-analysis of included studies was performed using the random-effects model.
Thirty-five studies with 134,100 schizophrenia patients were included. The overall voluntary admission rate of schizophrenia was 61.9 % (95 %CI: 52.3 %-70.7 %), while the involuntary rate was 43.0 % (95 %CI: 34.8 %-51.7 %). Subgroup analyses revealed that patients in Europe had significantly higher voluntary admission rates, while their North American counterparts were more likely admitted involuntarily. Papers published prior to 2008 reported higher involuntary admission rates. Meta-regression analyses showed that higher male percentage and higher study quality were significantly associated with higher voluntary admission rate.
Although the worldwide prevalence of voluntary admissions was higher than that of involuntary admissions, the latter was common for schizophrenia. With the continuing liberalization of mental health laws broadening community-based psychiatric services, the rate of voluntary psychiatric admissions is expected to further increase over time.
精神分裂症的自愿住院率在各项研究中差异很大。为了使该主题有充分的证据依据，进行准确的估计很重要。这项荟萃分析研究了精神分裂症患者全球范围内的自愿住院患病率。
系统检索了PubMed、EMBASE、PsycINFO、Cochrane图书馆、科学网和Medline数据库，检索时间从各数据库起始日期至2018年11月19日。使用随机效应模型对纳入研究进行荟萃分析。
纳入了35项研究，共134,100名精神分裂症患者。精神分裂症的总体自愿住院率为61.9%（95%置信区间：52.3%-70.7%），而非自愿住院率为43.0%（95%置信区间：34.8%-51.7%）。亚组分析显示，欧洲患者的自愿住院率显著更高，而北美患者更有可能非自愿住院。2008年之前发表的论文报告的非自愿住院率更高。Meta回归分析表明，男性比例较高和研究质量较高与自愿住院率较高显著相关。
虽然全球范围内自愿住院的患病率高于非自愿住院，但后者在精神分裂症中也很常见。随着精神卫生法律的持续放宽以及社区精神科服务的扩大，自愿精神科住院率预计会随着时间的推移进一步上升。
