诊断软件在重性精神障碍线索患者幻觉和妄想诊断中的应用

发布时间：2018-10-17 19:16

【摘要】：目的探讨《社区精神障碍诊断与公共安全风险评估软件》在重性精神障碍线索患者幻觉、妄想诊断中的应用价值。方法 2010年10月—2012年2月从云南省精神病医院和昆明市丰宁社区在册的精神障碍患者和存在社区精神病线索的患者中招募200例,由患者及其知情人进行《社区精神障碍诊断与公共安全风险评估软件》测试,在3 d内由2名精神科医生进行复测。比较软件的患者版本、知情人版本、综合诊断及医生诊断对于幻觉、妄想及常见重性精神障碍的检出率;并对医生诊断精神分裂症、持续性妄想障碍、双向障碍和抑郁障碍的患者,用软件进行幻觉、妄想症状检查。结果 (1)200例患者进行了问卷调查,其中回收全面有效问卷182份,参考有效问卷15份,无效问卷3份,有效问卷回收率为98.50%。软件的患者版本、知情人版本、综合诊断及医生诊断检出幻觉者分别为112例(56.85%)、104例(52.79%)、112例(56.85%)和110例(55.84%);检出妄想者分别为122例(61.93%)和126例(63.96%)、122例(61.93%)和126例(63.96%);检出常见重性精神障碍者分别为128例(64.97%)、137例(69.54%)、142例(72.08%)和138例(70.05%),软件各版本及医生对于幻觉、妄想及常见重性精神障碍的检出率间无差异(P0.05)。(2)106例医生诊断精神分裂症患者中,最常出现的幻觉、妄想症状是言语性听幻觉(73.58%),其次是关系妄想(70.75%)、被害妄想(52.83%)、影响妄想(48.11%)、疑病妄想(20.75%)、嫉妒妄想(17.92%)、夸大妄想(15.09%)、躯体幻觉(15.09%)和味幻觉(10.38%)。结论《社区精神障碍诊断与公共安全风险评估软件》对具有重性精神障碍线索的患者进行幻觉、妄想的检查,其检出率与专科医生诊断的检出率相近,故此软件可以作为社区精神卫生工作者和精神障碍家属辅助诊断幻觉、妄想的工具。
[Abstract]:Objective to explore the value of community psychiatric disorder diagnosis and public safety risk assessment software in the diagnosis of hallucination and delusion in patients with severe mental disorders. Methods from October 2010 to February 2012, 200 patients with mental disorders were recruited from Yunnan Psychiatric Hospital and Fengning Community of Kunming City. The patients and their insiders were tested with the Community Mental Disorder Diagnostic and Public Safety risk Assessment Software, and re-tested by two psychiatrists within 3 days. The patient version of the comparative software, the insider version, the comprehensive diagnosis and the doctor's diagnosis of hallucinations, delusions and common major mental disorders, and the diagnoses of schizophrenia, persistent delusions, Patients with two-way disorders and depression were examined with software for hallucinations and delusions. Results (1) A total of 182 questionnaires were collected from 200 patients, including 15 valid questionnaires and 3 invalid questionnaires. The effective questionnaire recovery rate was 98.50%. The patient version of the software, the insider version, There were 112 cases (56.85%), 104 cases (52.79%), 112 cases (56.85%) and 110 cases (55.84%) of hallucinations, 122 cases (61.93%) and 126 cases (63.96%) of delusion, 122 cases (61.93%) and 126 cases (63.96%), and 128 cases (64.97%), 137 cases (69.54%), 142 cases (72.08%), respectively. And 138 cases (70.05%) of software versions and doctors for hallucinations, There was no difference between the detection rates of delusions and common mental disorders (P0.05). (2). The most common hallucinations were found in 106 patients with schizophrenia diagnosed by doctors. The symptoms of delusion were verbal auditory hallucinations (73.58%), relationship delusion (70.75%), victimized delusion (52.83%), delusion of influence (48.11%), delusion of suspected disease (20.75%), delusion of jealousy (17.92%), delusions of exaggeration (15.09%), hallucinations of body (15.09%) and delusion of taste (10.38%). Conclusion the diagnostic and public safety risk assessment software for community mental disorders is similar to that of specialists in the detection of hallucinations and delusions in patients with major mental disorders. Therefore, the software can be used as a tool for community mental health workers and family members of mental disorders to help diagnose hallucinations and delusions.
【作者单位】：云南省精神病医院;
【分类号】：R749

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