精神疾病病人接受社區照護服務的預後預測因子

Outcome Predictors in Patients with Mental Illness Receiving Community Care Services: A Cohort Study

目的：研究精神疾病病人接受台北慈濟醫院提供的社區關懷服務後的預後因子。方法：從2011 年4 月1 日至2015 年9 月30 日收集接受社區關懷服務的精神疾病病人共319 案，做一個追蹤研究去分析個案預後因子。結果：病人合併人際衝突（修正後風險比 [AHR] =2.59, 95% CI = 1.52 - 4.41, p < 0.01）、急性精神症狀 (AHR = 1.99, 95% CI = 1.14 - 3.46, p

Objective: In this study, we intended to identify possible predictors of the clinical outcome in patients receiving community care services provided by Taipei Tzu-Chi Hospital. Methods: We recruited patients with mental illness who received community care services (CCS) between April 1, 2011 and September 30, 2015. We included 319 patients with mental illness in this study. In this cohort study, we compared CCC-participated patients with a favorable or an unfavorable outcomes. Results: The adjusted hazard ratios (AHR) with their 95% confidence intervals (CIs) of predictors such as having interpersonal conflicts (AHR = 2.59, 95% CI = 1.52 - 4.41, and p ＜ 0.01), active psychiatric symptoms (AHR = 1.99, 95% CI = 1.14 - 3.46, p ＜ 0.05), and illicit drugs use (AHR = 2.24, 95% CI = 1.18 - 4.28, p ＜ 0.05) were significantly higher than those of their control groups, meaning that those three clinical characteristics were predictors of a poor outcome in those CCS patients. Conclusion: Our findings highlight the need for psychiatric evaluation and intervention for patients with mental illness, comorbid with substance use disorder, or active psychiatric symptoms, and those who have ongoing interpersonal conflicts.