Hirdes Alice, de Almeida Mello Johanna, de Lara Machado Wagner, Ferlin Elton Luiz, Hirdes John P
Graduate Program in Nursing, Federal University of Rio Grande, Rio Grande, Brazil.
LUCAS - Centre for Care Consultancy, KU Leuven, Leuven, Belgium.
BMC Psychiatry. 2025 Apr 22;25(1):408. doi: 10.1186/s12888-025-06805-4.
Emergency services and mental health units in general hospitals play a central role in the initial care and treatment of individuals with mental disorders. Early diagnosis and treatment of mental disorders and substance abuse can reduce cognitive deficits in this population. This study aims to investigate the factors associated with cognitive impairment for people with mental health disorders and addictions.
This is a cross-sectional study performed in two general hospitals and an Emergency Care Unit (UPA) in cities in the metropolitan region of Porto Alegre, Rio Grande do Sul, Brazil. The interRAI Emergency Screener for Psychiatry (ESP) was used to describe the study population and to build an adjusted logistic model for the risk factors of cognitive impairment.
A total of 324 persons participated in the study (mean age: 41.8 ± 14.27, 50,2% female). The profile of people admitted to the different locations varied in several aspects according to the interRAI scales. The UPA received patients with acute conditions and higher scores on the Aggressive Behavior Scale, Mania Scale, the Scale of Harm to Others, and the Scale of Positive Symptoms. Patients at the university hospital had the highest rates of social withdrawal and a higher proportion of individuals with no insight into their mental health problems. The factors with the highest odds ratio were a diagnosis of schizophrenia (O.R.: 3.07; C.I. 1.13; 8.32), followed by self-care inability (O.R.: 2.87, 1.43; 5.77) and the aggressive behavior scale (2.85, 1.10; 7.44). A history of discharges, the Mania Scale and sleeping problems were also significantly associated with cognitive impairment. People being admitted to the UPA had lower odds of having cognitive impairment (O.R.: 0.18; 0.07; 0.45).
People diagnosed with schizophrenia were at very high risk of cognitive impairment. A prior history of discharges, inability to self-care, aggressive behavior, symptoms of mania and sleeping disturbances were also identified as risk factors. The interRAI EPS instrument showed to be useful to identify people with mental health disorders and substance abuse who were at risk of cognitive impairment. By early detecting these clients, professionals can refer them to adequate treatment, before symptoms increase.
综合医院的急救服务和精神卫生科在精神障碍患者的初始护理和治疗中发挥着核心作用。精神障碍和药物滥用的早期诊断和治疗可以减少该人群的认知缺陷。本研究旨在调查患有精神健康障碍和成瘾问题的人群中与认知障碍相关的因素。
这是一项在巴西南里奥格兰德州阿雷格里港大都市地区的两家综合医院和一个急救单元（UPA）进行的横断面研究。使用精神科interRAI急诊筛查工具（ESP）来描述研究人群，并建立认知障碍危险因素的调整逻辑模型。
共有324人参与了该研究（平均年龄：41.8±14.27，50.2%为女性）。根据interRAI量表，不同地点收治的患者在几个方面存在差异。UPA接收的是急性病患者，在攻击行为量表、躁狂量表、对他人的伤害量表和阳性症状量表上得分较高。大学医院的患者社交退缩率最高，且对自身心理健康问题缺乏洞察力的个体比例更高。比值比最高的因素是精神分裂症诊断（比值比：3.07；置信区间1.13；8.32），其次是自理能力不足（比值比：2.87，1.43；5.77）和攻击行为量表（2.85，1.10；7.44）。出院史、躁狂量表和睡眠问题也与认知障碍显著相关。入住UPA的患者出现认知障碍的几率较低（比值比：0.18；0.07；0.45）。
被诊断为精神分裂症的人认知障碍风险非常高。既往出院史、自理能力不足攻击行为、躁狂症状和睡眠障碍也被确定为危险因素。interRAI EPS工具显示有助于识别有精神健康障碍和药物滥用且有认知障碍风险的人。通过早期发现这些患者，专业人员可以在症状加重之前将他们转介到适当的治疗机构。
