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在老年精神分裂症患者中,多发病概况和特定原因死亡率
Alison R Hwong1, Yixia Li2, Michael A Steinman3
1Stanford Department of Psychiatry and Behavioral Sciences (ARH, DMB), Palo Alto, CA; VA Palo Alto Health Care System (ARH, DMZ, DMB), Palo Alto, CA.
概括
患有精神分裂症的老年人表现出不同的健康模式. 特定的多病态特征,如高医疗精神疾病,与增加的死亡风险有关,包括自杀和受伤.
科学领域:
- 老年精神病学是一门精神病学专业.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 精神分裂症显著影响到中晚年成年人,经常与其他医疗和精神疾病同时发生.
- 了解多病态模式对于管理精神分裂症老年人群的健康结果至关重要.
研究的目的:
- 在老年美国退伍军人精神分裂症中识别明显的多病态模式.
- 调查这些已识别的模式与特定原因死亡率之间的关联.
主要方法:
- 一项对91,680名患有精神分裂症的50岁以上美国退伍军人的纵向队列研究 (2012-2020年).
- 隐性类别分析,以根据医学和神经精神病学诊断来定义多病症概况.
- 细灰模型用于评估死亡风险 (自然原因,无意伤害,自杀).
主要成果:
- 确定了四个多病症类别:最小 (52%),高焦虑/PTSD (19%),精神病/物质使用障碍 (SUD) (19%) 和高医疗-精神病 (11%).
- 高医疗-精神病学组显示了最高的整体死亡风险 (HR 2.03).
- 精神病/SUD组因无意伤害死亡风险最高 (HR 2.24),高焦虑/PTSD组自杀死亡风险最高 (HR 1.37).
结论:
- 患有精神分裂症的老年退伍军人是一个异质的人群,具有多种多重疾病概况.
- 这些不同的模式与因特定原因死亡的显著不同风险有关.
- 干预措施必须根据这些子组的具体需求进行调整,以改善健康结果.
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