葡萄牙非自愿精神科住院治疗的相关因素。
Factors associated with involuntary psychiatric hospitalization in Portugal.
作者信息
Silva Manuela, Antunes Ana, Azeredo-Lopes Sofia, Loureiro Adriana, Saraceno Benedetto, Caldas-de-Almeida José Miguel, Cardoso Graça
机构信息
Comprehensive Health Research Centre (CHRC), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.
Lisbon Institute of Global Mental Health, Lisbon, Portugal.
出版信息
Int J Ment Health Syst. 2021 Apr 20;15(1):37. doi: 10.1186/s13033-021-00460-4.
BACKGROUND
Identifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012.
METHODS
Data from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors.
RESULTS
An increment of involuntary hospitalizations was associated with male gender [exp([Formula: see text]) = 1.31; 95%CI 1.06-1.62, p < 0.05], having secondary and higher education [exp([Formula: see text]) = 1.45; 95%CI 1.05-2.01, p < 0.05, and exp([Formula: see text]) = 1.89; 95%CI 1.38-2.60, p < 0.001, respectively], a psychiatric diagnosis of psychosis [exp([Formula: see text]) = 2.02; 95%CI 1.59-2.59, p < 0.001], and being admitted in 2007 and in 2012 [exp([Formula: see text]) = 1.61; 95%CI 1.21-2.16, p < 0.01, and exp([Formula: see text]) = 1.73; 95%CI 1.31-2.32, p < 0.001, respectively]. A decrease in involuntary hospitalizations was associated with being married/cohabitating [exp([Formula: see text]) = 0.74; 95%CI 0.56-0.99, p < 0.05], having experienced a suicide attempt [exp([Formula: see text]) = 0.26; 95%CI 0.15-0.42, p < 0.001], and belonging to the catchment area of three of the psychiatric services evaluated [exp([Formula: see text]) = 0.65; 95%CI 0.49-0.86, p < 0.01, exp([Formula: see text]) = 0.67; 95%CI 0.49-0.90, p < 0.01, and exp([Formula: see text]) = 0.67; 95%CI 0.46-0.96, p < 0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively].
CONCLUSIONS
The findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with several sociodemographic, clinical, and contextual factors. This information may help identify high-risk patients and inform the development of better-targeted preventive interventions to reduce these hospitalizations.
背景
确定哪些因素导致非自愿精神科住院治疗，可能有助于采取措施减少其发生频率。本研究调查了2002年、2007年和2012年来自葡萄牙五个精神科部门的患者非自愿住院治疗相关的社会人口学、临床和背景因素。
方法
从临床档案中提取所有入院患者的数据。采用泊松广义线性模型估计患者一年中非自愿住院次数与社会人口学、临床和背景因素之间的关联。
结果
非自愿住院次数增加与男性[exp([公式：见原文]) = 1.31；95%置信区间1.06 - 1.62，p < 0.05]、接受中等及高等教育[exp([公式：见原文]) = 1.45；95%置信区间1.05 - 2.01，p < 0.05，以及exp([公式：见原文]) = 1.89；95%置信区间1.38 - 2.60，p < 0.001]、精神病性诊断[exp([公式：见原文]) = 2.02；95%置信区间1.59 - 2.59，p < 0.001]，以及在2007年和2012年入院[exp([公式：见原文]) = 1.61；95%置信区间1.2'1 - 2.16，p < 0.01，以及exp([公式：见原文]) = 1.73；95%置信区间1.31 - 2.32，p < 0.001]有关。非自愿住院次数减少与已婚/同居[exp([公式：见原文]) = 0.74；95%置信区间0.56 - 0.99，p < 0.05]、有自杀未遂经历[exp([公式：见原文]) = 0.26；95%置信区间0.15 - 0.42，p < 0.001]，以及属于所评估的三个精神科服务机构的服务区域[分别对应马加良斯·莱莫斯医院、里斯本精神科中心医院和下阿连特茹地区卫生单位，exp([公式：见原文]) = 0.65；95%置信区间0.49 - 0.86，p < 0.01，exp([公式：见原文]) = 0.67；95%置信区间0.49 - 0.90，p < 0.01，以及exp([公式：见原文]) = 0.67；95%置信区间'0.46 - 0.96，p < 0.05]有关。
结论
研究结果表明，葡萄牙的非自愿精神科住院治疗与多个社会人口学、临床和背景因素相关。这些信息可能有助于识别高危患者，并为制定更具针对性的预防干预措施提供依据，以减少此类住院治疗。
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