目的 分析北京市社区精神分裂症患者危险行为相关因素.方法 数据来自在北京市5个区登记在册的精神分裂症的患者,采用回顾性研究,评估患者发生危险行为的相关因素.结果 786例精神分裂症患者中,发生危险行为195例,与无危险组比较,有危险组的年龄、文化水平、家庭经济状况、家族史、应激生活事件、幻觉妄想、情绪高涨、怪异行为、服药情况、就医态度方面均存在显著性差异(P＜0.05);多因素回归分析显示精神分裂症患者的6个危险因素:年龄(0R=0.116,P＜0.01)、文化水平(0R=0.395,P＜0.01)、家族史(0R=2.519,P＜0.01)、幻觉妄想(0R=3.032,P＜0.01)、情绪高涨(OR=1.991,P＜0.01)服药情况(OR=2.097,P＜0.05).结论 社区应加强评估精神分裂症患者发生危险行为的相关因素,并进行综合防范管理.

目的 编制社区精神障碍患者危险行为评估量表并进行信效度及预测效度研究.方法 随机抽取北京市西城区15个社区的400例社区严重精神疾病患者,使用编制的社区精神障碍患者危险行为评估量表进行风险评估,随访观察1年内危险行为发生情况.通过计算量表的内部一致性信度、评分者信度、重测信度来评价量表的信度和效度,使用ROC曲线分析法来评价量表的预测效果.结果 条目存在量表内部一致性α系数(Cronbach'sα)为0.830,各条目评分者信度组内相关系数ICC为0.619～0.800,各条目重测信度组内相关系数ICC为0.693～0.836;危险相关量表内部一致性α系数(Cronbach'sα)为0.837,各条目评分者信度组内相关系数ICC为0.598～0.765;各条目重测信度组内相关系数ICC为0.653～0.765;条目存在量表在1年内不同时段的ROC曲线下面积(AUC值)为0.861～0.935;危险相关量表在1年内不同时段的ROC曲线下面积(AUC值)为0.863～0.936.结论 编制社区精神障碍患者危险行为评估量表具有良好的信效度及预测效度,可以作为社区严重精神障碍患者危险行为评估的工具使用.

目的 探索影响精神分裂症住院患者发生危险行为的相关影响因素.方法 采用回顾性研究方法,在北京市根据地理分布采用方便抽样的方法选取4个区中5家精神专科医院,将2016年1月至10月住院的625例精神分裂症患者作为调查对象,使用自制的调查问卷进行调查,评估分析患者危险行为的发生及其相关影响因素.结果 单因素分析显示,与无危险组比较,危险行为组中性别、年龄阶段、家庭邻里关系、工作状态、应激生活事件、精神症状、服药情况、就医态度、既往威胁性言语等方面差异有统计学意义(P<0.05).多因素Logistic回归分析显示,年龄(OR=0.62,P=0.017)、生活应激事件(OR=2.08,P=0.001)、幻觉妄想(OR=1.77,P=0.026)、怪异行为(OR=1.61,P=0.02)、就医态度(OR=2.60,P=0.029)、既往威胁性言语(OR=6.77,P<0.001)与危险行为相关.结论 45岁以下、幻觉妄想、怪异行为、被动就医、生活应激事件、既往威胁性言语是精神分裂症住院患者发生危险行为的主要相关因素.

Objective To observe the effect of rehabilitation training combined with dietary intervention on bone mineral density in patients with chronic schizophrenia. Methods A totalof 128 long-term hospitalized patients with chronic schizophrenic were divided by random number table method into control group and research group, with 64 cases in each group. The research group received rehabilitation training combined with dietary intervention, and the control group received conventional intervention. Comparison were made on nutrient intake after intervention, changes of bone mineral density before and after intervention and occurrence of fragile fracture between the two groups. Results After intervention, the research group had higher intake of protein, calcium, phosphorus and vitamin A, D and other nutrients than the control group, and the difference was statistically significant (P<0.05) . After intervention, both groups had higher bone mineral density of lumbar spine and left femoral neck, and the research group had significantly higher bone mineral density than the control group. Their difference was statistically significant (P<0.05) . After 6 months of follow-up, the control group had 7 cases of fragile fracture (10.94％) , and the research group had 1 case of fragile fracture (1.61％) . The research group had lower incidence of fragile fracture than the control group, and the difference was statistically significant (P<0.05) . Conclusion Combination of dietary intervention and targeted rehabilitation training can improve the bone mineral density of patients with schizophrenia and reduce the incidence of fragile fracture.

目的 探讨团体心理治疗对恢复期精神分裂症患者生活质量及社会功能的影响.方法 选择120例住院的恢复期精神分裂症患者,采用随机数字法分为研究组和对照组.研究组在服用原有药物的基础上额外给予连续12次团体心理治疗;对照组除没有接受团体治疗外,其它条件与研究组相同,观察为期12周.在入组时及12周末分别对研究组和对照组进行精神分裂症患者生活质量量表(SQLS)、个体和社会功能量表(PSP)的评估.结果 治疗12周末两组患者生活质量量表得分明显低于基线水平(33.85±6.80 vs 51.22±5.60,44.26±7.17vs 52.41±5.80,P＜0.05),研究组显著低于对照组(33.85±6.80 vs44.26±7.17,P＜0.001);两组患者社会功能量表得分高于基线水平(56.58±4.35vs50.25±3.50,53.23±3.52 vs 50.10±3.67,P＜0.05),研究组显著高于对照组(56.58±4.35vs53.23±3.52,P＜0.001).结论 对恢复期精神分裂症患者给予团体心理治疗,可以提高患者生活质量,促进其社会功能的康复,帮助患者更好地适应社会.

目的:了解北京市西城区社区居民心理健康知识和精神障碍防治核心信息知晓情况,为有针对性地开展精神卫生工作提供依据.方法:采用整群随机抽样方法抽取北京市西城区常住居民为调查对象,开展社区居民心理健康知识知晓率问卷调查.结果:北京市西城区常住居民心理健康知识知晓率,即总体应答正确率为72.2％,其中基本知晓率为51.8％,部分知晓率为42.2％,较少知晓率为6.0％;知晓率问卷得分与性别、年龄阶段、婚姻状况、文化程度均相关(P<0.05),女性正确应答率明显高于男性(P<0.05).结论:北京市西城区社区常住居民心理健康知识和精神障碍防治核心信息总体知晓情况良好,但精神卫生知识、精神卫生相关节日等知晓较低.

目的:探讨社区精神分裂症患者骨质疏松情况及相关因素.方法:收治精神分裂症患者128例,分为住院组和社区组,分析患者性别、年龄、骨密度、体重指数、催乳素等指标,同时分析骨质疏松的相关因素.结果:社区患者和住院患者比较,年龄、体重指数和骨密度均出现明显改变(P<0.05);且多元线性回归分析骨质疏松与年龄、体重指数相关.结论:社区精神分裂症患者骨密度高于住院患者,且体型瘦弱的高龄患者,容易出现骨质疏松.

Objective To investigate the psychiatric comorbidities between eating disorder and mental disorders in axis Ⅰ of DSM-Ⅳ in female patients.Methods A total of 62 female patients with eating disorder were selected and assessed with Structured Clinical Interview for DSM (SCID) for the psychiatric comorbidities.Result There were 69.4％ for the rate of only one kind of psychiatric comorbidity and 58.1％,38.7％,9.6％ for the rates of mood disorder,anxiety disorder,substance use disorder comorbidities.There was 33.9％ for the rate of at least two kinds of psychiatric comorbidities.There was 85.2％ for the comorbidity of bulimia nervosa.The rates of the comorbidities of anxiety disorder and at least two kinds of psychiatrics in patients with bulimia nervosa were significantly higher than those in patients with anorexia nervosa(P ＜ 0.05).Conclusion It's common for the psychiatric comorbidities between eating disorder and mental disorders in axis Ⅰ of DSM-Ⅳ in female patients.

Objective The study examined the risk factors for Osteoporosis of patients with chronic schizophrenia.Methods A total of 148 patients with schizophrenia was divided into the normal BMD (60 patients) and decreased BMD (88 patients),Clinical assessment instruments included Ca,P,body mass index (BMI),prolactin (PRL),PANSS,bone mineral density (BMD).Results The prevalence of osteoporosis was 59.5 ％ (n=148),The patients in normal BMD compared with those who decreased BMD in sex,age,PRL,BMI,weekly exercises (min),the difference was significant (P ＜ 0.05);Multiple logistic regression analysis revealed that age,PRL and BMI were significantly associated with osteoporosis.Conclusion Factors that are associated with Osteoporosis in schizophrenic inpatients are older age,higher BMI,higher PRL level.

Objective To observe the clinical efficacy of Jintiange capsules on the treatment of osteopenia and osteoporosis in patients with chronic schizophrenia. Methods A total of 59 patients with schizophrenia were randomly divided into the observation group (45 patients) and the control group (14 patients). Patients in the observation group received Jintiange capsules, while those in the control group received calcium carbonate treatment. The clinical symptoms, biochemical indicators, and bone mineral density ( BMD) were compared in the 24 weeks after the treatment. Results After 24 weeks of the treatment, the back pain and weak of the back and the knee relieved in the patients (P<0?01). Serum calcium and BMD increased in the two groups after the treatment comparing to those before the treatment, and the difference was significant (P<0?05). But the difference between the two groups was not significant (P>0?05). Conclusion Jintiange capsules is effective in the treatment of osteoporosis in patients with chronic schizophrenia. Jintiange capsules reduce pain of the back and knee, relieve the weak of the lower extremities, and improve life of quality in patient with chronic schizophrenia.