J Psychiatr Pract. 2024 Jan 1;30(1):2-12. doi: 10.1097/PRA.0000000000000756.
Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients.
We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge.
Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73 d vs. 10.52±10.37 d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients.
Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.
需要住院治疗的严重精神障碍是导致精神疾病负担的致残状况。它们带来了更大的临床挑战，凸显了彻底探索日常临床实践中出现的变量的必要性。在这项研究中，我们评估了性别差异在多大程度上可以描述一大群精神科住院患者。
我们在意大利的 2 所教学医学中心进行了一项横断面研究，共纳入 2358 名连续入住精神科急诊病房的患者。我们探索并描述了性别差异，例如精神科诊断的患病率、自杀意念、自杀企图、精神疾病发病年龄、物质或酒精滥用的存在、住院时间、住院次数、非自愿入院的存在、出院类型以及出院时的药物治疗。
女性患者主要被诊断为双相情感障碍或人格障碍。与男性患者相比，女性患者一生中自杀企图的发生率明显更高（23.1%比 16.5%，P<0.001），住院时间更长（11.43±10.73 天比 10.52±10.37 天，t=-2.099，gl=2356，P=0.036）。与女性患者相比，男性患者非自愿入院的比例更高（25.1%比 19.7%，χ2=9.616，gl=1，P=0.002），使用非法物质的比例更高（34.1%比 20.9%，χ2=51.084，gl=1，P<0.001），酒精滥用的发生率更高（21.3%比 14.7%，χ2=17.182，gl=1，P<0.001）。最后，与女性患者相比，抗抑郁药和锂更常被开给女性患者，而其他心境稳定剂更常被开给男性患者。
我们的真实世界研究结果突出了精神科病房中严重精神障碍患者的性别差异，并建议进行进一步的调查，以帮助了解伴随致残临床状况的轨迹。
