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經急診室收住院之精神分裂症病人的臨床特徵

Clinical Characteristics of Patients with Schizophrenia Referred for Hospitalization from the Psychiatric Emergency Room

摘要


目的:本研究目的在於探討急診室精神分裂症病人的特質,試圖了解其人口學及臨床特徵,是否可成為急診收住院之預測因子。方法:本研究為一回溯性研究,查閱民國94年1月到94年6月底期間,台灣北部某一區域教學醫院急診室之精神分裂症病患,收集其人口學及臨床特徵,並比較住院組與非住院組之差別。結果:急診室精神分裂症病人中,共57.9%接受住院治療,其中以無職業、經由警消協助就診、有明顯精神病症狀、合併自傷或自殺、有暴力之傾向或行為,以及有合併酒精或藥物濫用之病人,較易接受住院治療。在進行多變項logistic迴歸分析後發現,最能影響住院的預測因子,是有明顯精神病症狀,以及有暴力之傾向或行為。結論:精神分裂症病人尋求急診精神醫療時,有半數以上會接受精神科住院治療,其中決定收住院的因素,以有明顯精神病症狀(OR=26.1,95%CI= 3.23-210.48),以及有暴力攻擊之傾向或行為(OR=16.2, 95%CI=3.56-73.85),最能預測接受住院治療。

關鍵字

精神分裂症 急診室 住院

並列摘要


Objective: This study was to explore which predictors of patients with schizophrenia would be hospitalized after visiting the emergency room in Taiwan. This study was found that more than 50% of patients with schizophrenia who visited the psychiatric emergency room received psychiatric hospitalization. Method: The demographic and clinical characteristics of patients with schizophrenia who visited emergency room between January 1 to June 30, 2005 were analyzed by chart review, We compared the difference between patients with schizophrenia hospitalized and not hospitalized. Results: The predictors of patient with schizophrenia in emergency room to be hospitalized were unemployed, referred by police. obviously psychotic symptoms, suicide attempt behavior, violent tendency behavior and alcohol/substance abuse. Through multiple logistic regression analysis, we found that the most significant predictors were obviously psychotic symptoms and violent tendency/behavior. Conclusions: The results of this study was found that more than 50% patient with schizophrenia who visited the psychiatric emergency room received psychiatric hospitalization. The most significant predictors of hospitalization were obviously psychotic symptoms (OR=26.l, 95%C1=3.23-2l0.48) and violence tendency behavior (OR=l6.2, 95%C1=3.56-73.85). (Full text in Chinese)

並列關鍵字

schizophrenia emergency room hospitalization

參考文獻


精神衛生法
Bengelsdorf H,Church JO,Kaye RA,Orlowski B,Alden DC(1993).The cost effectiveness of crisis intervention. Admission diversion savings can offset the high cost of service.J Nerv Ment Dis.181,757-762.
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Gillig PM,Hillard JR,Bell J,Combs HE,Martin C,Deddens JA(1989).The psychiatric service holding area: Effect on utilization of inpatient resources.Am J Psychiatry.146,369-372.

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