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英国住院治疗儿童期起病精神分裂谱系障碍与非精神病性障碍的功能结局和患者满意度。

Functional outcomes and patient satisfaction following inpatient treatment for childhood-onset schizophrenia spectrum disorders vs non-psychotic disorders in children in the United Kingdom.

机构信息

National and Specialist Acorn Lodge Inpatient Children's Unit, Child and Adolescent Mental Health Clinical Academic Group, South London and the Maudsley NHS Foundation Trust, London, UK.

Faculty of Education, Universidad de los Andes, Santiago, Chile.

出版信息

Early Interv Psychiatry. 2021 Apr;15(2):412-419. doi: 10.1111/eip.12973. Epub 2020 May 20.

Abstract

AIM

The aim of this study was to compare clinical characteristics and treatment outcomes between children with Childhood-onset schizophrenia spectrum disorders (COSS) and children with other severe non-psychotic psychiatric conditions (non-COSS), all admitted to a national mental health inpatient children's unit.

METHODS

We conducted a retrospective study of all children discharged from a national children's inpatient unit in the United Kingdom, between 2009 and 2018. We compared functional and treatment outcomes and satisfaction with treatment in COSS with non-COSS in the whole sample and separately for male and female patients.

RESULTS

A total of 211 children (55% boys) were included in the sample. The mean age on admission was 129.7 months (10.8 years; age range, 6-12).Twenty cases were diagnosed with COSS (9.5%). In the whole sample, COSS patients had significantly lower Children's Global Assessment Scale (CGAS) scores on admission compared to non-COSS (P = .006). There was a trend towards children with COSS as a group having a longer admission (M = 194.6 days, SD = 125.4) compared to non-COSS (M = 135.8 days, SD = 86.2), (P = .053). Females with COSS seemed to have more significant differences compared to females with non-COSS, in particular, longer admissions (P = .016) and worse CGAS scores at discharge (P = .04), whilst in males, these differences seemed to be attenuated.

CONCLUSIONS

Children with COSS have lower functioning at the point of inpatient admission and possibly longer admissions, but similar satisfaction with treatment at discharge from hospital compared with non-COSS. Females with COSS may have worse functional outcomes compared to non-COSS at discharge.

摘要

目的

本研究旨在比较儿童发病的精神分裂症谱系障碍(COSS)和其他严重非精神病性精神疾病(非 COSS)患儿的临床特征和治疗结局,所有患儿均收入英国国家精神卫生住院儿童病房。

方法

我们对 2009 年至 2018 年期间在英国国家儿童住院病房出院的所有儿童进行了回顾性研究。我们比较了 COSS 与非 COSS 患者在全样本中的功能和治疗结局以及对治疗的满意度,并分别对男性和女性患者进行了比较。

结果

共纳入 211 例患儿(55%为男性)。入院时的平均年龄为 129.7 个月(10.8 岁;年龄范围为 6-12 岁)。20 例患儿被诊断为 COSS(9.5%)。在全样本中,COSS 患儿入院时的儿童总体评估量表(CGAS)评分明显低于非 COSS 患儿(P=0.006)。COSS 患儿的住院时间也有延长的趋势(M=194.6 天,SD=125.4),而非 COSS 患儿的住院时间(M=135.8 天,SD=86.2)(P=0.053)。COSS 女性患者与非 COSS 女性患者相比,功能差异更为显著,特别是住院时间更长(P=0.016)和出院时 CGAS 评分更差(P=0.04),而男性患者的这些差异则有所减弱。

结论

COSS 患儿在入院时的功能较低,可能住院时间更长,但出院时对治疗的满意度与非 COSS 患儿相似。与非 COSS 相比,COSS 女性患者出院时的功能结局可能更差。

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