Kallert T W, Leisse M
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden.
Gesundheitswesen. 1998 Nov;60(11):649-55.
In accordance with the intentions of the Saxonian planning for restructuring mental health services the establishment of social psychiatry services (SPS) was evaluated. The results presented here originate from one part of a public health research project. In 8 selected SPS a client-centred documentation of care episodes (n = 825) was conducted during the period 8/1995-1/1997 using a specifically designed instrument. In the whole group (54% women; mean age women (49.6 years) > men (43.2 years); 39% schizophrenic, 13% affective disorders, 21% alcoholism) significant differences in the distribution of diagnoses could be found on comparing urban and rural regions: 50% schizophrenic disorders (urban) vs. 20% (rural); 34.5% dependency disorders (rural) vs. 12% (urban). Concerning the chronicity of mental disorders (whole group: first contact with psychiatric institution for 30% of the clientele < 1985; 67% formerly hospitalised) there are considerable variations between SPS in urban and rural areas. Cooperative contacts with other complementary psychiatric institutions as well as the spectrum of items of care also differ significantly between the investigated SPS. Related to the diagnoses some impressive concentrations of care/therapeutical activities could be identified: e.g. home visits (37.2% of the activities) are very important especially for schizophrenic patients, consultations focusing on practical issues (35%) are of eminent significance for dependency disorders. The results lead to the conclusion that the Saxonian SPS already realise an extensive and time-consuming spectrum of social psychiatric activities. However, strengthening these institutions on a professional and personal level as well as the further establishment of psychiatric facilities close to the community seem necessary to achieve concentration on main diagnostic groups, establishment of more homogeneous care strategies, and implementation of coordinative SPS-activities.
按照萨克森州精神卫生服务结构调整规划的意图，对社会精神病学服务（SPS）的设立进行了评估。此处呈现的结果源自一项公共卫生研究项目的一部分。在1995年8月至1997年1月期间，使用专门设计的工具，在8个选定的社会精神病学服务机构中，以客户为中心记录了护理事件（n = 825）。在整个群体中（54%为女性；女性平均年龄（49.6岁）大于男性（43.2岁）；39%为精神分裂症患者，13%为情感障碍患者，21%为酗酒者），比较城市和农村地区时，在诊断分布上可发现显著差异：精神分裂症障碍患者占50%（城市），而农村为20%；依赖障碍患者占34.5%（农村），城市为12%。关于精神障碍的慢性程度（整个群体：30%的患者首次接触精神病机构的时间早于1985年；67%曾住院治疗），城市和农村地区的社会精神病学服务机构之间存在相当大的差异。所调查的社会精神病学服务机构在与其他补充性精神病机构的合作联系以及护理项目范围方面也存在显著差异。与诊断相关，可以确定一些护理/治疗活动的显著集中点：例如，家访（占活动的37.2%）对精神分裂症患者尤为重要，针对实际问题的咨询（占35%）对依赖障碍具有至关重要的意义。结果得出结论，萨克森州的社会精神病学服务机构已经开展了广泛且耗时的一系列社会精神病学活动。然而，为了实现对主要诊断群体的集中关注、制定更统一的护理策略以及实施协调性的社会精神病学服务活动，似乎有必要在专业和人员层面加强这些机构，并进一步建立靠近社区的精神病设施。
