1
|
Hou MR, Wang J, Xue JH, Pei JQ, Shi Y, Li XW. Gender differences among long-stay inpatients with schizophrenia in China: A cross-sectional study. Heliyon 2023; 9:e15719. [PMID: 37159715 PMCID: PMC10163644 DOI: 10.1016/j.heliyon.2023.e15719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 04/03/2023] [Accepted: 04/19/2023] [Indexed: 05/11/2023] Open
Abstract
Objective We sought to examine the independent correlates of long-term hospitalization in a sample of Chinese inpatients with schizophrenia (SCZ) from a gender-based perspective. Methods This was a cross-sectional study that was carried out in a tertiary psychiatric hospital. All adult inpatients in this hospital were screened from January to March 2020, 251 of whom were identified as long-stay inpatients with SCZ (LSIS) and 224 as short-stay inpatients with SCZ (SSIS). Demographic and clinical information of the two groups was collected through medical records, scale assessments and interviews. Gender differences were analyzed, and independent correlates of long-stay between genders were explored by logistic regression analyses. Results Compared to SSIS, greater proportions of LSIS patients were male (64.1%), single (82.1%), unemployed (81.7%) and had no family caregivers (54.2%). For LSIS per se, proportionally more males were single (88.8%), had no family caregiver (65.8%), had concomitant physical disease (65.2%) and had a history of hazardous behavior (27.3%) than their female counterparts. For females, the top independent risk factors for a long stay included poor functioning (OR = 5.9, 95% CI: 2.9-12.0), older age (OR = 4.3, 95% CI: 2.1-9.1) and being single (OR = 3.9, 95% CI: 1.8-8.4). Similar to women, both older age (OR = 5.3, 95% CI: 2.5-11.2) and poor functioning (OR = 4.0, 95% CI: 2.1-7.9) were also independent factors for long-term hospitalization of male patients; however, having no family caregiver (OR = 10.2, 95% CI: 4.6-22.6) was the primary risk factor for men. Conclusions Both clinical and nonclinical factors play important roles in long-term hospitalization in Chinese patients with schizophrenia. There are overlaps and distinctions across genders with respect to the independent factors of long stays. These findings provide clues for developing better service strategies for this population, and highlight the importance of paying attention to gender differences in further research in this field.
Collapse
Affiliation(s)
- Ming-ru Hou
- Department of General Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, 156 Qianrong Road, Wuxi, Jiangsu 214151, China
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Jun Wang
- Department of Clinical Psychology, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, 156 Qianrong Road, Wuxi, Jiangsu 214151, China
- Corresponding author. Department of Clinical Psychology, The Affiliated Mental Health Center of Jiangnan University, 156 Qianrong Road, Wuxi, Jiangsu 214151, China.
| | - Jian-hua Xue
- Tongji University School of Medicine, Shanghai 200092, China
| | - Jian-qin Pei
- Department of General Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, 156 Qianrong Road, Wuxi, Jiangsu 214151, China
| | - Yan Shi
- Nursing Department, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai 200072, China
| | - Xian-wen Li
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Corresponding author. School of Nursing, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| |
Collapse
|
2
|
Chen Y, Li W. Prevalence, Influencing Factors, and Cognitive Characteristics of Depressive Symptoms in Elderly Patients with Schizophrenia. Neuropsychiatr Dis Treat 2021; 17:3645-3654. [PMID: 34934317 PMCID: PMC8684420 DOI: 10.2147/ndt.s341297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the prevalence, influencing factors, and cognitive characteristics of depressive symptoms in elderly patients with chronic schizophrenia. PATIENTS AND METHODS A total of 241 elderly patients with chronic schizophrenia and 156 healthy controls were enrolled in this study. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms; the Positive and Negative Syndrome Scale was used to assess psychotic symptoms; and both the Mini-Mental State Examination and Montreal Cognitive Assessment were used to assess overall cognitive function, while the Activity of Daily Living Scale was used to assess daily living ability. RESULTS The prevalence of depressive symptoms was 48.5% (117/241) in elderly patients with chronic schizophrenia, which was substantially higher than that of normal controls (17.3%, 27/156). Using a stepwise binary logistic regression analysis, we found that high education (p=0.006, odds ratio [OR]=1.122, 95% confidence interval [CI]:1.034-1.218) and hypertension (p=0.019, OR=0.519, 95% CI: 0.300-0.898) were influencing factors for the comorbidity of depressive symptoms. Compared with individuals without depressive symptoms, individuals with depressive symptoms usually display worse overall cognitive function and more severe impairment of activities of daily living, but fewer psychotic symptoms. Interestingly, the GDS score was negatively correlated with the course of the disease (r=-0.157, p=0.016), suggesting that patients who had recently been admitted to the hospital were more likely to develop depression. CONCLUSION Elderly patients with chronic schizophrenia are often associated with higher levels of depression. Therefore, their overall cognitive function is worse, and their activities of daily living are more seriously impaired. Therefore, these patients should be provided with appropriate psychological comfort, especially those who have recently been admitted to the hospital.
Collapse
Affiliation(s)
- Yaopian Chen
- Department of Sleep Medicine, Wenzhou Seventh People's Hospital, Wenzhou, People's Republic of China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| |
Collapse
|
3
|
Zhu Y, Hu X, Yang B, Wu G, Wang Z, Xue Z, Shi J, Ouyang X, Liu Z, Rosenheck R. Association between migrant worker experience, limitations on insurance coverage, and hospitalization for schizophrenia in Hunan Province, China. Schizophr Res 2018; 197:93-97. [PMID: 29195746 DOI: 10.1016/j.schres.2017.11.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 11/07/2017] [Accepted: 11/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND While transnational migration has been shown to be a risk factor for schizophrenia, studies have not examined whether massive internal rural-to-urban migration in China in recent years has increased the risk of hospitalization for schizophrenia, or schizophrenia symptom severity among migrants. METHOD In a sample of patients acutely hospitalized with schizophrenia in Changsha, Hunan Province, China (N=334), the proportion of past migrant workers among patients was compared to the proportion of past migrant workers in the general adult population of Hunan. Past migrants were also compared to non-migrants on age of onset, and on symptom severity using the Positive and Negative Syndrome Scale (PANSS). The risk ratio for being a migrant among those hospitalized for schizophrenia was stratified by age and gender subgroups. Multiple regression analysis was used to evaluate group differences in age of onset and symptoms. RESULTS Of 334 patients diagnosed with schizophrenia hospitalized for <180days, 150 (44.9%) were identified as having been migrant workers compared to 31.0% in the general adult population of Hunan for a risk ratio of 1.45, a risk that was higher for women (2.19) than for men (1.09). Migrant workers also had higher scores than others on total PANSS symptoms. CONCLUSION Migrant workers appear to be at greater risk of hospitalization for schizophrenia than other residents of Hunan and showed more severe psychopathology. These findings may reflect specific lack of health insurance coverage for workers migrating to non-native provinces in China, thereby delaying access to treatment.
Collapse
Affiliation(s)
- Yifan Zhu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Xinran Hu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China.
| | - Bo Yang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Guowei Wu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Zheng Wang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Zhimin Xue
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Jincheng Shi
- Xiangya School of Public Health, Central South University, Changsha, PR China
| | - Xuan Ouyang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China.
| | - Zhening Liu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China; The State Key Laboratory of Medical Genetics, Central South University, PR China.
| | | |
Collapse
|
4
|
Dimitri G, Giacco D, Bauer M, Bird VJ, Greenberg L, Lasalvia A, Lorant V, Moskalewicz J, Nicaise P, Pfennig A, Ruggeri M, Welbel M, Priebe S. Predictors of length of stay in psychiatric inpatient units: Does their effect vary across countries? Eur Psychiatry 2018; 48:6-12. [PMID: 29331601 DOI: 10.1016/j.eurpsy.2017.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/10/2017] [Accepted: 11/10/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous studies in individual countries have identified inconsistent predictors of length of stay (LoS) in psychiatric inpatient units. This may reflect methodological inconsistencies across studies or true differences of predictors. In this study we assessed predictors of LoS in five European countries and explored whether their effect varies across countries. METHODS Prospective cohort study. All patients admitted over 14 months to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and United Kingdom were screened. Putative predictors were collected from medical records and in face-to-face interviews and tested for their association with LoS. RESULTS Average LoS varied from 17.9days in Italy to 55.1days in Belgium. In the overall sample being homeless, receiving benefits, social isolation, diagnosis of psychosis, greater symptom severity, substance use, history of previous admission and being involuntarily admitted predicted longer LoS. Several predictors showed significant interaction effects with countries in predicting LoS. One variable, homelessness, predicted a different LoS even in opposite directions, whilst for other predictors the direction of the association was the same, but the strength of the association with LoS varied across countries. CONCLUSIONS The same patient characteristics have a different impact on LoS in different contexts. Thus, although some predictor variables related to clinical severity and social dysfunction appear of generalisable relevance, national studies on LoS are required to understand the complex influence of different patient characteristics on clinical practice in the given contexts.
Collapse
|
5
|
Wu BJ, Liao HY, Chen HK, Lan TH. Psychopathology, psychopharmacological properties, decision-making capacity to consent to clinical research and the willingness to participate among long-term hospitalized patients with schizophrenia. Psychiatry Res 2016; 237:323-30. [PMID: 26847945 DOI: 10.1016/j.psychres.2016.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 11/18/2015] [Accepted: 01/11/2016] [Indexed: 11/22/2022]
Abstract
Many studies discuss factors related to the decision-making capacity to consent to clinical research (DMC) of patients with schizophrenia. However, these studies rarely approached willingness to participate and the association between psychopharmacological properties (e.g., antipsychotic-induced side effects) and DMC. This study aimed to explore factors related to DMC and willingness to participate in patients with schizophrenia. All 139 patients with schizophrenia were assessed with the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and other measures. A linear regression model was used to find the predictors of MacCAT-CR scores. A logistic regression model was used for exploring the predictors of willingness to participate. Patients with more severe negative symptoms performed poorly in DMC outcomes. In addition, females, those with fewer years of education and reduced cognitive function are more likely to experience difficulties in decision-making. Forty-three subjects (30.4%) chose to participate. Patients with higher level of positive symptoms, longer length of stay, higher burden of anticholinergics and users of atypical antipsychotics were more likely to participate in a clinical study which aimed to "enhance cognition". These finding suggest that research investigators should consider many variables for patients who require more intensive screening for impaired DMC.
Collapse
|
6
|
Subica AM, Allen JG, Frueh BC, Elhai JD, Fowler JC. Disentangling depression and anxiety in relation to neuroticism, extraversion, suicide, and self-harm among adult psychiatric inpatients with serious mental illness. Br J Clin Psychol 2015; 55:349-370. [DOI: 10.1111/bjc.12098] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/25/2015] [Indexed: 12/22/2022]
Affiliation(s)
| | - Jon G. Allen
- The Menninger Clinic; Houston Texas USA
- Baylor College of Medicine; Houston Texas USA
| | - B. Christopher Frueh
- The Menninger Clinic; Houston Texas USA
- Baylor College of Medicine; Houston Texas USA
- University of Hawaii; Hilo Hawaii USA
| | | | - J. Christopher Fowler
- The Menninger Clinic; Houston Texas USA
- Baylor College of Medicine; Houston Texas USA
| |
Collapse
|