关键词: 精神障碍, 社区精神卫生服务, 规范管理

Abstract:
Objective　To explore the effect of community-based standardized mental disorders management on patients with severe mental disorders in Xinjiang's Karamay.Methods　We conducted this study from July 2012 to December 2015.We selected 296 patients with 6 types of severe mental disorders from the permanent residents（living at their current residence for 6 months or longer） of 5 communities〔Kunlun and Jinlong（pilot communities），Shengli，Yinhe and Tianshan（non-pilot communities）〕 sampled from Karamay by using cluster random sampling，including 85 from Kunlun and Jinshan communities（experimental group），and 211 from Shengli，Yinhe and Tianshan communities（control group）.The experimental group received community-based standardized mental disorders management（including basic，case and emergency management by the institutions in an internet-based three-level mental disorders control and prevention system），while the control group received the conventional hospitalized treatment and outpatient follow-ups.The management effects were evaluated by hospitalization rate，management rate，rate of mental disorders remaining stable over the intervention period，rate of participating in social activities，treatment rate，drop-out rate，rate of receiving emergency management，rate of causing minor affrays，and rate of causing accidents.Results　The hospitalization rates in the experimental group in 2013，2014，2015 were all much lower than those of the control group（P<0.05）.The experimental group demonstrated obviously higher hospitalization rate in 2012 compared with 2013，2014，2015（χ2=12.66，P<0.01；χ2=4.67，P=0.03；χ2=13.07，P<0.01）.The rate of participating in social activities was similar in both groups（P>0.05）.The experimental group showed much higher management rate，rate of mental disorders remaining stable over the intervention period，treatment rate，and notably lower drop-out rate compared with the control group（P<0.05）.The rate of receiving emergency management in the experimental group in 2013 was similar to that of 2014（χ2=0.03，P=0.84），but was significantly higher than that of 2015（χ2=5.49，P=0.02）.The experimental group exhibited a much decreased rate of causing minor affrays（χ2=7.37，P=0.02），as well as a severely declined rate of causing accidents（χ2=8.27，P=0.02）.Conclusion　The community-based standardized mental disorders management demonstrated good effect on patients with severe mental disorders and achieved good socio-economical benefits，which contributes to the stable development of Karamay，so it can be used more extensively.

Key words: Mental disorders, Community mental health services, Standard management