成年精神病门诊患者合并躯体疾病：危险因素、心理功能和生活质量结局。
Comorbid physical illnesses in adult outpatients with psychotic disorders: risk factors, psychological functioning, and quality of life outcomes.
机构信息
Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
Department of Early Psychosis Intervention, Institute of Mental Health, Singapore, 539747, Singapore.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2021 Sep;56(9):1633-1643. doi: 10.1007/s00127-021-02034-8. Epub 2021 Feb 22.
PURPOSE
In contrast to global research, where physical comorbidity in psychotic disorders is established, only a few studies have been conducted in Southeast Asia. With a concerning trend of chronic physical illnesses emerging in adults below the age of 65, an investigation into comorbid chronic physical illnesses in adults diagnosed with psychotic disorders is necessary. This study aims to explore the risk factors, psychological functioning, and quality of life outcomes associated with comorbidity in adults below the age of 65, diagnosed with psychotic disorders, in a multi-ethnic non-Western setting.
METHODS
Electronic medical records of 364 patients with psychotic disorders who had provided written consent to participate were screened for co-occurring physical conditions. The majority of participants were female (53.7%), Chinese (69%), single (74.5%), and had tertiary and above education (43%). They were approximately 35 years old on average and the mean age of onset for psychosis was 26.7 years old.
RESULTS
Comorbid physical illnesses were present in approximately a third of adults with psychotic disorders (28%). They typically reported cardiovascular-related diseases, respiratory, and skin conditions. Comorbidity was significantly related to lower physical quality of life. As compared to other types of psychotic disorders, schizophrenia was significantly related to a greater frequency of comorbid physical conditions. Multinomial regression analyses revealed that age, age of onset, Malay and Indian ethnicities were significant factors.
CONCLUSION
Physical comorbidity in adults below the age of 65 is common, signifying an emerging need to place greater attention into the screening and emphasis on the physical care needs of this age group. Finally, more research is needed to understand the impact of common co-occurring acute and chronic cardiovascular, skin, and respiratory diseases locally.
目的
与全球研究相反，精神障碍患者存在身体共病，在东南亚开展的此类研究较少。由于 65 岁以下成年人中慢性躯体疾病的发病率呈上升趋势，因此有必要调查此类人群精神障碍患者的共患慢性躯体疾病情况。本研究旨在探讨在多民族非西方环境下，65 岁以下被诊断为精神障碍的成年人中，躯体共病与风险因素、心理功能和生活质量结局的相关性。
方法
对 364 名同意参与研究的精神障碍患者的电子病历进行筛选，以了解是否存在共患躯体疾病。大多数患者为女性（53.7%）、华人（69%）、单身（74.5%），接受过高等教育（43%）。他们的平均年龄为 35 岁左右，精神病的平均发病年龄为 26.7 岁。
结果
约三分之一的精神障碍成年人（28%）存在躯体共病。他们通常患有心血管相关疾病、呼吸系统疾病和皮肤病。共病与较低的生理生活质量显著相关。与其他类型的精神障碍相比，精神分裂症与更多的躯体共病显著相关。多项分类回归分析显示，年龄、发病年龄、马来族和印度族裔是显著相关的因素。
结论
65 岁以下成年人的躯体共病较为常见，这表明需要更加关注这一年龄组的筛查，并重视他们的躯体护理需求。最后，还需要更多的研究来了解当地常见的急性和慢性心血管疾病、皮肤病和呼吸系统疾病的共同影响。
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