目的了解精神分裂症患者首次正式开始治疗前的疾病未治疗期间(duration of untreated illness,DUI)和精神病未治疗期间(duration of untreated psychosis,DUP)及其影响因素。方法应用诺丁汉起病症状量表(Nottingham onset schedule,NOS)调查上海市精神卫生中心的精神分裂症患者,共收集117例。同时,应用自编问卷对患者家属进行访谈,调查可能影响患者及时就诊的因素。结果①精神分裂症患者DUI中位数是181天,DUP中位数是84天。②首发非特异性精神症状以失眠和情绪障碍最为常见,出现频度超过50%;首发精神病性症状以幻听和被害妄想最为常见,出现频度达到47%。③影响患者就诊的主要因素是家属不认识精神病和患者不愿接受诊治。④以DUI中位数181天将患者区分为长DUI组和短DUI组,发现:长DUI组中回答家庭成员意见不一致是延误就诊因素的比例显著高于短DUI组(x^2=3.9,P〈0.05)。结论精神分裂症患者从发病到开始治疗的疾病未治疗期间较长。影响DUI和DUP的因素是多方面的,值得进一步深入研究。
Objective: To evaluate the duration of untreated illness (DUI), duration of untreated psychosis (DUP) and their influencing factors in schizophrenia. Methods: DUI and DUP were evaluated among 117 schizophrenia patients with Nottingham Onset Schedule (NOS). Their influencing factors were investigated by interviewing the relatives of patients with a self - made scale. Results:The median DUI and DUP were 181 days and 84 days respectively. The most common prodromal symptoms were insomnia and emotional disorders. The most common first psychotic symptoms were auditory hallucinations and delusion of persecution. Factors interfering the patients'diagnosis and management were that the family's ignorance of the disease and the reluctance of the patients to receive medical care. More relatives of long DUI patients than those of short DUI patients reported that the disagreement among the family members might impede the patients' management (x^2 = 3.9,P 〈 0.05). Conclusion:The duration of untreated illness in schizophrenia was longer. The influencing factors of DUI and DUP are muhi - dimensional and deserved further study.