Yang Chunyu, Zhong Xiaomei, Zhou Huarong, Wu Zhangying, Zhang Min, Ning Yuping
The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
Neuropsychiatr Dis Treat. 2020 Sep 10;16:2073-2082. doi: 10.2147/NDT.S261223. eCollection 2020.
In people with psychosis, physical comorbidities are highly widespread and leading contributors to the untimely death encountered. Readmission rates in psychiatric patients are very high. Somatic comorbidities could be one of the considerable risk factors for psychiatric rehospitalization. Nevertheless, much less is known about the relation between physical comorbidities and psychiatric readmission. We aimed to investigate the association between physical comorbidities and psychiatric readmission in Han Chinese patients with psychiatric disorders.
We used administrative data for January 1, 2009 to December 31, 2018 from the headquarters of the Affiliated Brain Hospital of Guangzhou Medical University to identify adults with schizophrenia, unipolar depression or bipolar disorder discharged from hospital. Data were extracted on sociodemographic and clinical characteristics. The Charlson comorbidity index (CCI) was used to assess the existence of significant physical comorbidity. Cox proportional hazards regression estimated rehospitalization risk after discharge.
A total of 15,620 individuals were included in this study, with the mean age of 35.1 years (SD = 12.8), and readmission occurred for 23.6% of participants. Survival analysis showed that physical comorbidities were statistically and significantly associated with psychiatric readmission, even after the adjustment for the number of psychiatric comorbidities, other sociodemographic and clinical variables.
Our results suggest that somatic comorbidities are related with higher rates of psychiatric readmission. Hence, to treat psychosis more effectively and to reduce rehospitalization, it is crucial to treat physical comorbidities promptly and adequately. It is absolutely necessary to bring somatic comorbidities to the forefront of psychiatric treatment and research.
在患有精神病的人群中，躯体合并症非常普遍，是导致过早死亡的主要因素。精神科患者的再入院率非常高。躯体合并症可能是精神科再住院的一个重要风险因素。然而，关于躯体合并症与精神科再入院之间的关系，我们所知甚少。我们旨在调查汉族精神障碍患者躯体合并症与精神科再入院之间的关联。
我们使用了广州医科大学附属脑科医院总部2009年1月1日至2018年12月31日的管理数据，以识别出院的患有精神分裂症、单相抑郁症或双相情感障碍的成年人。提取了社会人口学和临床特征数据。使用查尔森合并症指数（CCI）评估显著躯体合并症的存在情况。Cox比例风险回归估计出院后的再住院风险。
本研究共纳入15620人，平均年龄35.1岁（标准差 = 12.8），23.6%的参与者再次入院。生存分析表明，即使在调整了精神科合并症的数量、其他社会人口学和临床变量后，躯体合并症与精神科再入院在统计学上仍有显著关联。
我们的结果表明，躯体合并症与较高的精神科再入院率相关。因此，为了更有效地治疗精神病并减少再住院，及时、充分地治疗躯体合并症至关重要。将躯体合并症置于精神科治疗和研究的前沿绝对必要。
