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

10.29478/TJP.200709.0003

陳淵渝(Yuan-Yu Chan)；林志強(Jyh-Chyang Lin)；諶立中(Lih-Jong Shen)；楊斯年(Szu-Nian Yang)

精神分裂症 ； 急診室 ； 住院 ； schizophrenia ； emergency room ； hospitalization

台灣精神醫學

21卷3期（2007 / 09 / 01）

167 - 185

繁體中文

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。

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)

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