臺灣地區精神病患者之社會文化特徵及療養結果研究

A STUDY OF SOCIOCULTURAL CHARACTERISTICS AND OUTCOME OF CARE OF PSYCHOTIC PATIENTS IN TAIWAN

1962名從台灣省各鄕鎮市區（N=1,425）及公私立精神病院（N=547）抽樣出來的精神病患者接受了調查訪問，以求了解他們的社會文化特徵和療養結果。低社會階層，教育程度差，無業及婚姻殘缺被發現是他們的特徵。有86.3%的社區病人由其家人照顧生活，其餘的不是被單獨禁閉（3.4%）即為獨居（10.3%）。將近一半的病患尋求過民俗療法；而從發病到接受精神科治療之間的時間延誤相當長的居多。五分之一的社區病人從未找過精神科醫師治療，而在調查期間有一半病人未接受任何形式之治療，只有三分之一病人接受住院治療，其中只有三分之一出院後有規則服藥。大部份社區病人退縮或四處流浪，有工作的不到10%。住院病人當中有15%可以獨立工作卻無法出院返回社區。大份長期收容的病人整日被關在病房不見天日。作者強調公立精神醫療機構和社會福利措施之亟需加強改進。

1962 psychotic patients sampled from both communities (N=1,425) and mental hospitals (N=537) were investigated on their sociocultural characteristics and conditions of care and current social function. Low social class with poor education, joblessness, and lack of marital life was found to be characteristic among these patients. 86.3% of community patients lived with their families, and the rest were found to be locked or living alone. Lack of first-degree relatives and unstable mental condition were the main factors leading to custodial care and living alone. A high percentage of patients sought traditional healer for help and the time-lag between the onset of illness and psychiatric treatment was thus delayed considerably. One-fifth of community patients had never sought psychiatric help and half of all patients did not receive any treatment during the investigation period. Only one-third of all patients ever hospitalized had received regular medication after their discharge. Most of the community patients had been withdrawn from the society and only less than 10% had a job. There were 15% of hospitalized patients who could work independently but were unable to return to the community. Most of the patients under custodial care had been locked in ward day by day and had not seen the sunshine for years. They appeared severely retarded. The need of increasing and improving current public mental illness services and welfare was stressed.