2016年全国严重精神障碍患者管理治疗现状分析

摘要

目的 分析2016年全国严重精神障碍患者管理治疗情况及与2014年和2015年比较相关指标的变化.方法 采用描述性分析方法,对2011年8月1日至2016年12月31日全国及各省(自治区、直辖市)国家严重精神障碍信息系统使用情况以及患者登记、管理、治疗情况等进行分析.结果 截至2016年底,全国2 801个区县(98.14％,2 801/2 854)使用信息系统.全国在册患者5 401 150例,报告患病率3.96‰(5 401 150/1 362 466 686);在管患者4 873 977例,管理率90.24％(4 873 977/5 401 150),规范管理患者3 665 720例,规范管理率67.87％(3 665 720/5 401 150);服药患者2 528 143例,服药率51.87％(2 528 143/4873 977);规律服药患者1 594 562例,规律服药率32.72％(1 594 562/4873 977);病情稳定患者3 265 761例,病情稳定率68.68％(3 265 761/4 754 801).病情稳定率与管理率、规范管理率、服药率、规律服药率呈正相关(r分别为0.578、0.733、0.495、0.536,均P＜0.05).与2015年相比,系统使用区县增加27个,在册患者增加479 645例,管理率、规范管理率、服药率、规律服药率、病情稳定率分别增加3.84％、22.93％、3.16％、2.31％、7.37％.2016年登记的精神分裂症、偏执性精神病、分裂情感性障碍、双相情感障碍、癫痫所致精神障碍、精神发育迟滞伴发精神障碍患者未治期分别为3.89、4.40、3.06、3.01、5.64、16.56年,均短于2015年.结论 2016年严重精神障碍患者信息系统覆盖范围扩大,登记患者人数持续增长,患者管理和服药水平有所提高,未治期持续缩短.%Objective To analyze the management and treatment situation for patients with psychosis in China in 2016,and compare with those data in 2014 and 2015,in order to provide a reference for policy making and services delivering.Methods Descriptive method was used to analyze the information system usage and the demographic characteristics,registration,management and treatment situation of the patients with psychosis.Data was obtained from ‘National Information System for Psychosis’ and traced from 1st August 2011 to 31st December 2016.Results By the end of 2016,the information system was applied by 2 801 counties (98.14％,2 801/2 854) to register patients with psychosis in China,5401 150 patients were registered,and prevalence of registered psychosis was 3.96‰ (5 401 150/1 362 466 686).In 2016,4 873 977 patients received the follow-up services by primary health care workers,and 3 665 720 patients were followed up regularly (at least once per 3 months).The follow-up rate and regular follow-up rate were 90.24％ (4 873 977/5 401 150) and 67.87％ (3 665 720/5 401 150) respectively.Moreover,2 528 143 patients were treated by antipsychotics,and 1 594 562 patients took medication regularly (according to the prescriptions).The medication-taking rate and regular medication-taking rate were 51.87％ (2528 143/4873977) and 32.72％ (1 594562/4873977) respectively.3 265 761 patients were in stable condition during the whole year and the rate of being stable was 68.68％ (3 265 761/4 754 801),which was positively correlated with follow-up rate,regular follow-up rate,medication-taking rate and regular medication-taking rate(r=0.578,0.733,0.495,0.536,all P＜0.05).Comparing with 2015,there are extra 27 counties and 479 645 more registered patients in 2016 and all indicators above were higher in 2016.Duration of untreated schizophrenia,bipolar disorder,delusional disorder,schizoaffective disorder,psychotic disorder with epilepsy,mental retardation with psychotic symptoms was 3.89,4.40,3.06,3.01,5.64,16.56 years respectively,all of which were shorter than 2015.Conclusions Services for patients with psychosis were significantly improved in 2016.The coverage of the system was expanded and the number of registered patients increased sustainably,and at the same time the duration of untreated psychosis decreased continuously with better management and treatment.