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中国农村重症精神疾病患者的躯体疾病共病情况及其影响因素

Physical illness comorbidity and its influencing factors among persons with severe mental illness in Rural China.

作者信息

Wei Dan-Nuo, Wang Yi-Zhou, Deng Shu-Yu, Cohen Alex, Luo Wei, Liu Bo, Ran Mao-Sheng

机构信息

Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR.

London School of Hygiene & Tropical Medicine, UK.

出版信息

Asian J Psychiatr. 2022 May;71:103075. doi: 10.1016/j.ajp.2022.103075. Epub 2022 Mar 14.

Abstract

BACKGROUND

Comorbid physical illness is a common cause of death in people with severe mental illness (SMI) worldwide. In rural China, the prevalence of physical illness comorbidity among persons with SMI remains unclear. This study aimed to examine non-communicable physical illness comorbidity and its risk factors among people with SMI in a rural area of China.

METHODS

A mental health survey, using the International Classification of Disease (ICD-10), was conducted in six townships of Xinjin District, Chengdu, China in 2015.

RESULTS

A total of 724 persons with SMI were included in this study, and 37.8% of them had at least one physical illness. The most common physical illnesses were hypertension (10.5%) and diabetes (5.8%). More physical comorbidity was reported among persons with affective disorders than persons with schizophrenia. Many participants (37.4%) had never received antipsychotic treatment, and of those, 51.6% reported having a physical illness comorbidity. Significant associations were found between physical illness comorbidity and participants' family economic status, family size, age at onset of mental disorder, treatment status, and symptom severity.

CONCLUSIONS

Our findings indicate the need of an integration of medical and psychiatric care in primary care. It also suggests that poverty and having never received treatment for mental health problems negatively affect the health of persons with SMI, which deserve more attention. Researchers and policymakers can take these findings into account to develop health policies and improve the mental and physical health care in rural China.

摘要

背景

躯体共病是全球严重精神疾病(SMI)患者常见的死亡原因。在中国农村地区,SMI患者中躯体疾病共病的患病率仍不清楚。本研究旨在调查中国农村地区SMI患者的非传染性躯体疾病共病情况及其危险因素。

方法

2015年在中国成都新津区的6个乡镇开展了一项采用国际疾病分类(ICD - 10)的心理健康调查。

结果

本研究共纳入724例SMI患者,其中37.8%至少患有一种躯体疾病。最常见的躯体疾病是高血压(10.5%)和糖尿病(5.8%)。情感障碍患者的躯体共病情况比精神分裂症患者更多。许多参与者(37.4%)从未接受过抗精神病治疗,其中51.6%报告有躯体疾病共病。在躯体疾病共病与参与者的家庭经济状况、家庭规模、精神障碍发病年龄、治疗状况和症状严重程度之间发现了显著关联。

结论

我们的研究结果表明在基层医疗中需要整合医疗和精神科护理。这也表明贫困以及从未接受过心理健康问题治疗对SMI患者的健康有负面影响,值得更多关注。研究人员和政策制定者可以考虑这些研究结果来制定卫生政策,改善中国农村地区的精神和躯体卫生保健。

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