Abstract:

Objective　To explore the clinical characteristics and development trend in patients with psychiatric diseases in a hospital from 2014 to 2023. Methods　The clinical data of 33 745 patients in the Department of Psychiatry, Dongguan Seventh People's Hospital from 2014 to 2023 were retrospectively analyzed, including gender, age, admission/discharge date, International Classification of Diseases (ICD) -10 code, clinical diagnosis, case type, etc. The patients' basic situation, overall disease distribution, and annual distribution, gender distribution, and age distribution of the top 10 diseases were analyzed. Results　The overall number of psychiatric patients increased from 2014 to 2023, and fluctuated from 2022 to 2023. There were 19 664 males and 14 081 females, and the overall male-female ratio was 1.4:1. The majority of the patients were between 31 and 45 years old, with a total of 11 828 cases, accounting for 35.05% of the total. From 2014 to 2023, the number of the patients ≤17 years old showed a fluctuating upward trend. The main type of cases was general type, with a total of 25 495 cases, accounting for 75.55% of the total. The number of acute type, difficult type, and critical type patients showed a fluctuating upward trend, and the fluctuation was obvious in 2022 and 2023. According to the ICD-10 four-digit code classification, there were 186 kinds of diseases in 45 disease entities, of which the top 4 were schizophrenia, bipolar disorder, psychotic disorder, and depression. Among the top 10 diseases, the number of the inpatients with psychotic disorder showed a fluctuating downward trend, while the remaining 9 diseases showed a fluctuating upward trend as a whole, and the change trends of schizophrenia, bipolar disorder, and depression were the same. The number of the inpatients with behavioral and emotional disorders usually occurring in childhood and adolescence increased year by year. The number of the patients with depression, anxiety-related psychiatric disorders, and behavioral and emotional disorders usually occurring in childhood and adolescence were all on the rise in 2023. Among the gender distributions of the top 10 diseases, schizophrenia, bipolar disorder, psychotic disorders, alcohol, drug, and psychoactive substance related addictive psychiatric disorders, mania, mental retardation related psychiatric disorders were more prevalent in males than in females, while depression, behavioral and emotional disorders usually occurring in childhood and adolescence, anxiety-related disorders, and recurrent depression were more prevalent in females than in males, and 95.01% (1 714/1 804) of alcohol, drug, and psychoactive substance related addictive psychiatric disorders occurred in men. The patients with the top 10 diseases were mostly 18-45 years old, and 96.49% (550/570) of the patients with behavioral and emotional disorders usually occurring in childhood and adolescence were ≤17 years old. Conclusions　From 2014 to 2023, the overall number of psychiatric patients showed a fluctuating upward trend, mainly middle-aged and young men, and the diseases were mainly schizophrenia, bipolar disorder, psychotic disorder, and depression. The number of the inpatients with behavioral and emotional disorders usually occurring in childhood and adolescence increased year by year. The majority of the patients with alcohol, drug, and psychoactive substance related addictive psychiatric disorders were men. We should pay more attention to the prevention and treatment of psychiatric diseases, especially schizophrenia and bipolar disorder, and pay more attention to the adolescents' mental health.

Key words:

Department of Psychiatry, Mental illness, Clinical features, Development trend

摘要：

目的　探讨2014—2023年某院精神科患者临床特征及发展趋势。方法　回顾性分析2014—2023年东莞市第七人民医院精神科33 745例患者的临床资料，包括性别、年龄、入院/出院日期、国际疾病分类（International Classification of Diseases，ICD）-10编码、临床诊断、病例分型等；分析患者基本情况，整体病种分布，前10位病种的年度分布、性别分布、年龄分布。结果　2014—2023年精神科患者数量整体上升，2022—2023年出现波动，其中男19 664例，女14 081例，整体男女比为1.4：1；患者年龄以31～45岁为主，共11 828例，占总数的35.05%，2014—2023年≤17岁患者数量总体呈波动上升趋势；病例分型以一般型为主，共25 495例，占总数的75.55%，急型、疑难型、危重型患者数量总体呈波动上升趋势，2022—2023年波动明显。按ICD-10四位编码分类，共有45个病种186种疾病，其中前4位为精神分裂症、双相障碍、精神病性障碍、抑郁。前10位病种中精神病性障碍住院患者数量呈波动下降趋势，其余9种病症整体呈波动上升趋势，精神分裂症、双相障碍、抑郁变化趋势一致，通常在童年和青少年期发病的行为和情绪障碍住院患者数量逐年上升，2023年抑郁、焦虑相关的精神性疾病、通常在童年和青少年期发病的行为和情绪障碍患者数量均上升。前10位病种性别分布中，精神分裂症，双相障碍，精神病性障碍，酒精、药物和精神活性物质相关的成瘾性精神性疾病，躁狂，精神发育迟缓、迟滞相关的精神性疾病患者的男性占比均高于女性，抑郁、通常在童年和青少年期发病的行为和情绪障碍、焦虑相关的精神性疾病、复发性抑郁患者的女性占比均高于男性，酒精、药物和精神活性物质相关的成瘾性疾病95.01%（1 714/1 804）发生在男性中；前10位病种多发于18～45岁，通常在童年和青少年期发病的行为和情绪障碍患者中96.49%（550/570）≤17岁。结论　2014—2023年精神科患者数量整体呈波动上升趋势，患者以中青年男性为主，病种以精神分裂症、双相障碍、精神病性障碍、抑郁为主，通常在童年和青少年期发病的行为和情绪障碍住院患者数量数逐年上升，酒精、药物和精神活性物质相关的成瘾性疾病患者大多数是男性。临床应更加重视精神疾病的防治，尤其要注意精神分裂症、双相障碍的防治，同时要关注青少年心理健康。

关键词:

精神科, 精神疾病, 临床特征, 发展趋势