Geng Feng, Jiang Feng, Conrad Rachel, Liu Tingfang, Liu Yuanli, Liu Huanzhong, Tang Yi-Lang
Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.
Hefei Fourth People's Hospital, Hefei, China.
Front Psychiatry. 2020 Dec 3;11:607464. doi: 10.3389/fpsyt.2020.607464. eCollection 2020.
This nationally representative sample investigates demographic, diagnostic and clinical features associated with both voluntary and involuntary psychiatric hospitalization among children and adolescents psychiatrically hospitalized in China. As part of an official national survey, 41 provincial tertiary psychiatric hospitals in China were selected. Data from 196 children and adolescents who were discharged from these psychiatric hospitals from March 19 to 31, 2019 were retrieved and analyzed. 1. Psychotic symptoms, depressive symptoms and self-injury/suicide were the most common reasons of admission. Girls were significantly likely to be admitted due to depressive symptoms, whereas boys were more likely to be admitted due to aggressive behaviors. 2. The overall rate of involuntary admission was 32.1% ( = 63). Compared to patients who were admitted voluntarily, those who were admitted involuntarily had lower GAF scores on admission, were older, were more likely to present with psychotic symptoms, manic symptoms or aggressive behavior as primary reason for admission, were less likely to present with depressive symptoms, had a significantly longer length of stay, were more likely to be diagnosed with schizophrenia and were less likely to be diagnosed as depressive disorder. 3. A logistic regression showed that depressive symptom as primary reason for admission was significantly associated with voluntary admission (OR = 0.159, < 0.001), along with two other factors: age ( < 0.01) and a lower GAF score at admission ( < 0.001) were significantly associated with involuntary admission. The rate of involuntary psychiatric hospitalization among children and adolescents is higher in China than in other regions. Developing more specific and more operational criteria to guide involuntary psychiatric admission for child and adolescent patients is of urgency and great importance to ensure appropriate treatment of these patients and protect their rights.
这个具有全国代表性的样本调查了在中国因精神问题住院治疗的儿童和青少年中，与自愿和非自愿精神科住院相关的人口统计学、诊断和临床特征。作为一项官方全国性调查的一部分，在中国选取了41家省级三级精神病医院。检索并分析了2019年3月19日至31日从这些精神病医院出院的196名儿童和青少年的数据。1. 精神病症状、抑郁症状以及自我伤害/自杀是最常见的入院原因。女孩因抑郁症状入院的可能性显著更高，而男孩因攻击性行为入院的可能性更大。2. 非自愿入院的总体比例为32.1%（n = 63）。与自愿入院的患者相比，非自愿入院的患者入院时的总体功能评估（GAF）得分更低、年龄更大、更有可能以精神病症状、躁狂症状或攻击性行为作为入院的主要原因、出现抑郁症状的可能性更小、住院时间显著更长、更有可能被诊断为精神分裂症且被诊断为抑郁症的可能性更小。3. 逻辑回归显示，以抑郁症状作为入院主要原因与自愿入院显著相关（比值比[OR] = 0.159，P < < 0.001），另外还有两个因素：年龄（P < 0.01）和入院时较低的GAF得分（P < 0.001）与非自愿入院显著相关。中国儿童和青少年非自愿精神科住院率高于其他地区。制定更具体、更具操作性的标准以指导儿童和青少年患者的非自愿精神科入院，对于确保这些患者得到适当治疗并保护他们的权利而言迫在眉睫且至关重要。
