Sato Yoshiteru, Sugawara Norio, Kawamata Yasushi, Shimoda Kazutaka, Yasui-Furukori Norio
Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan.
Department of Neuropsychiatry, Hirosaki Medical University, Graduate School of Medicine, Hirosaki, Japan.
Neuropsychiatr Dis Treat. 2023 Jun 2;19:1369-1378. doi: 10.2147/NDT.S409882. eCollection 2023.
Low health literacy has been associated with adverse outcomes in health maintenance and the course of chronic physical illness. In particular, anxiety disorders can also affect one's physical health, causing issues including cardiovascular, respiratory, gastrointestinal and immune system disorders. However, there are no reports on physical health literacy among Japanese patients with mental illness.
A patient background questionnaire, the Japanese version of the Ten-Item Personality Inventory, and the Japanese version of the Health Literacy Scale (HLS-EU-Q47; European Health Literacy Survey Questionnaire) were distributed face to face to 1000 psychiatric outpatients. A total of 785 valid responses including 211 patients with schizophrenia, 261 patients with mood disorders, and 234 patients with anxiety disorders were obtained by mail.
Health literacy was "limited" in 52% of patients with schizophrenia, 51% of those with mood disorders, and 38% of those with anxiety disorders. Among patients with mood disorders, there were no differences between those with major depressive disorder and those with bipolar disorder. Anxiety disorders were associated with higher health literacy than schizophrenia and mood disorders (odds ratio (OR) 1.85, 95% confidence interval (95% CI) 1.07, 3.34), and in terms of personality, neuroticism (OR 0.85, 95% CI 0.75, 0.97) and openness (OR 0.85, 95% CI 0.74, 0.98) were associated with limited health literacy, while agreeableness (OR 1.36, 95% CI 1.18, 1.57) and extraversion OR 1.34, 95% CI 1.17, 1.52) were associated with higher health literacy.
The results of this study indicate limited health literacy in patients with mental illness, in particular, limited health literacy in outpatients with schizophrenia and mood disorders. In addition, gender and some personality traits were associated with physical health literacy. Based on these results, physical health education should be individualized.
健康素养较低与健康维护及慢性躯体疾病病程中的不良后果相关。特别是，焦虑症也会影响一个人的身体健康，引发包括心血管、呼吸、胃肠和免疫系统紊乱等问题。然而，尚无关于日本精神疾病患者身体健康素养的报道。
向1000名精神科门诊患者面对面发放患者背景调查问卷、日文版十项人格量表以及日文版健康素养量表（HLS-EU-Q47；欧洲健康素养调查问卷）。通过邮件共获得785份有效回复，其中包括211例精神分裂症患者、261例心境障碍患者和234例焦虑症患者。
52%的精神分裂症患者、51%的心境障碍患者和38%的焦虑症患者健康素养“有限”。在心境障碍患者中，重度抑郁症患者和双相情感障碍患者之间没有差异。焦虑症患者的健康素养高于精神分裂症和心境障碍患者（优势比（OR）1.85，95%置信区间（95%CI）1.07，3.34），就人格而言，神经质（OR 0.85，95%CI 0.75，0.97）和开放性（OR 0.85，95%CI 0.74，0.98）与有限的健康素养相关，而宜人性（OR 1.36，95%CI 1.18，1.57）和外向性（OR 1.34，95%CI 1.17，1.52）与较高的健康素养相关。
本研究结果表明精神疾病患者的健康素养有限，尤其是精神分裂症和心境障碍门诊患者的健康素养有限。此外，性别和一些人格特质与身体健康素养相关。基于这些结果，身体健康教育应个体化。
