用泊松回归模型识别精神分裂症谱系障碍复发的有效因素

O. Davarinejad, Tahereh Mohammadi Majd, M. Abbasi, S. Eskandari
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摘要

背景与目的:精神分裂症是最严重的精神疾病之一,具有复发性。频繁的复发对患者的思想、行为和人际关系都有破坏性的影响。这些可能导致患者个人和社会表现的中断。本研究的目的是确定增加复发次数的危险因素。方法:在这项回顾性队列研究中,提取了2015年至2019年间在法拉比医院至少住院一次的SSD患者的医疗记录数据。为确定精神分裂症复发的相关因素,分别采用单因素、多因素分析和多元泊松回归分析。使用STATA 14.1进行分析。结果:401份病历资料中,男性255例(63.6%),女性146例(36.4%)。复发1105例,其中男性683例,女性422例。65例复发5 ~ 11次。在考虑的变量中,就业状况(RR=0.85, P值=0.043)、年龄(RR=0.99, P值=0.03)、发病方式(RR=0.78, P值=0.027)和药物依从性(RR=1.67, P<0.001)对再入院的增加有显著影响。结论:本研究结果显示,精神分裂症发病年龄小、病情逐渐加重、失业和药物不遵医嘱对精神分裂症患者复发风险增加有显著影响。考虑到上述危险因素,似乎有必要采取预防和治疗措施,以减少复发的风险。有不依从的患者可以接受教育和咨询。
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Identification of Effective Factors in Recurrence of Schizophrenia Spectrum Disorder Using Poisson Regression Model
Background and Objectives: Schizophrenia is one of the most severe psychiatric disorders that has a recurrent nature. Frequent relapses have destructive impacts on patient’s thoughts, behaviors and relationships. These can lead to disruption of personal and social performance of patient. The aim of this study was to identify risk factors for increasing the number of relapses. Methods: In this retrospective cohort study, data from medical records of individuals with SSD who were admitted at least once to Farabi Hospital between 2015 and 2019 years extracted. To determine factors related to recurrence of Schizophrenia, Univariate and multivariate analysis and multivariate Poisson Regression were performed respectively. Analysis was done using STATA 14.1. Results: Based on extracted data from 401 medical records, 255 (63.6%) were males and 146 (36.4%) were females. A total of 1105 relapse were observed in males with 683 cases, and females with 422 cases. 65 patient experienced relapse from 5 to 11 times. Among considered variables, Employment status (RR=0.85, P-value=0.043), age (RR=0.99, P-value=0.03), Mode of Onset (RR=0.78, P-value=0.027) and Medication Adherence (RR=1.67, P<0.001) were significant on increasing readmission. Conclusion: According to the results of this study, the young age of onset of schizophrenia, the gradual onset of the disorder, unemployment and drug non-compliance had a significant effect on increasing the risk of recurrence in patients with schizophrenia. considering above risk factors, it seems necessary to perform preventive and therapeutic measures to reduce the risk of relapses. Patients with non-adherence can be under education and counseling.
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