慢性精神分裂症患者的临床数字和死亡率:一项局部评估

S. Shafti
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摘要

研究人员一直报道,与一般人群相比,精神障碍患者的死亡率较高。在伊朗,没有系统的精神病病例登记,这使我们无法准确地研究精神病患者的死亡率。当前研究的目的是确定一组非西方慢性老年精神分裂症患者的死亡率和临床死亡概况。方法:以拥有220张床位(男女老年患者各110张)的拉兹精神病院慢性老年科为具体调查对象。在目前的回顾性调查中,上述高级病房过去60个月(2014年4月至2019年8月)记录的所有死亡病例都被纳入本研究。临床诊断基本上也是基于《精神疾病诊断与统计手册》第5版(DSM-5)。结果:在800例慢性老年精神分裂症患者中,经该院病死率委员会登记的死亡69例。结果表明,本研究评估的老年精神分裂症男性和女性患者的年死亡率分别为0.015(0.15 / 1000人/年)和0.017(0.17 / 1000人/年)左右,显著低于目前当地的粗死亡率(p<0.000)。女性精神分裂症患者的死亡年龄明显大于男性精神分裂症患者(p< 0.001),但男性和女性精神分裂症患者的预期寿命均明显短于公众预期寿命(p< 0.000)。此外,在目前的评估中,虽然心脏病是老年精神分裂症患者的主要死亡原因,但自杀、跌倒、吸毒或结核病等原因根本不适用。结论:老年精神分裂症患者的死亡率明显低于当地居民的粗死亡率,但女性死亡患者的年龄明显长于男性死亡患者,男性和女性死亡患者的预期寿命均明显低于当地居民的预期寿命。心脏疾病也是老年精神分裂症患者死亡的主要原因。
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Clinical Figure and Rate of Mortality Among Chronic Schizophrenics: A Local Assessment
Introduction: Researchers have consistently reported that people with mental disorders have elevated mortality compared with the general population. In Iran there are not systematic psychiatric case registers that could allow us to study precisely the mortality of psychiatric patients. The aim of the current study was to determine the mortality rate and clinical profile of death in a group of non-western chronic elderly schizophrenic patients. Methods: chronic geriatric subdivision of Razi Psychiatric hospital with a capacity around 220 beds (110 for each of male and female elderly patients) had been selected as the specific arena of investigation. For the present retrospective survey, all recorded deceases during the last sixty months (April of 2014-August 2019) in the said senior wards had been included in the current study. Clinical diagnosis, too, was essentially based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition (DSM-5). Results: Among eight-hundreds and frothy chronic elderly schizophrenic patients, sixty-nine deceases had been registered by the mortality committee of the hospital. As said by results, the annual rate of mortality among elderly schizophrenic patients in the present assessment was around 0.015 (0.15 per 1,000 individuals per year) and 0.017 (0.17 per 1,000 individuals per year) among male and female aged patients, respectively, which were significantly lower than current native crude death rate (p<0.000). While the age of the expired female patients was significantly more than the died male schizophrenics (p < 0.001), the life expectancy of both male and female expired patients was significantly shorter than the public’s life expectancy (p< 0.000). Besides, in the present evaluation, while cardiac illness was the main leading cause of death among old schizophrenics, reasons like suicide, falls, drug use or tuberculosis, were not applicable at all. Conclusion: While the rate of mortality among elderly schizophrenics was significantly lower than public’s crude death rate, age of the deceased female patients was significantly longer than the male expired patients and life expectancy of both male and female died patients was significantly lower than native public’s life expectancy. Cardiac disorder, as well, was the main leading cause of death among aged schizophrenic patients.
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