일 정신보건센터 등록 환자의 사회인구학적 및 임상적 특성 변화 : 2008년과 2012년의 비교

Changes of Sociodemographic and Clinical Characteristics of Patients Registered in a Community Mental Health Center: Comparing 2008 with 2012

본 연구의 결과를 통하여 정신보건센터에 등록된 환자들의 사회인구학적, 사회보장혜택의 변화 및 임상적 특성이 점차 변화되고 있음을 확인하였다. 기혼자의 비율 및 직업 활동을 하는 환자의 비율의 증가는 정신질환자들의 결혼 및 직업에 대한 욕구의 증가와 삶의 질 향상에 대한 요구의 증가를 반영하는 것으로 볼 수 있다. 또한 의료보호 환자 및 정신장애 등록 환자의 증가를 통하여 정신질환자들의 사회복지에 대한 요구가 증가하는 것을 시사하고 있다. 임상적으로 정신병적 장애 외의 정신질환으로 진단받은 환자들이 증가하여 이들에 대한 정신보건서비스의 개발과 시행이 필요한 것으로 보인다. 복용하고 있는 치료 약물 또한 차이를 보이고 있으며 비정형 항정신병약물을 복용하는 환자들의 증가는 정신보건센터에 등록된 해당 환자들의 삶의 질과 함께 치료결과를 향상시킬 수 있을 것으로 추정할 수 있다.

Objective This study was designed to investigate the changes of sociodemographic and clinical characteristics of patients who were registered in a community mental health center. Methods The patients enrolled in this study were those registered in Suwon City Community Mental Health Center in 2008 and 2012, and there were 440 and 460 patients, respectively. The authors analyzed demographic data, medical insurance status, registration status of mental disability and clinical characteristics, such as diagnosis, type of medical institution the patients received medical care from, medication, duration of illness, Brief Psychiatric Rating Scale and global assessment function scores. Results There were more married patients in 2012 than in 2008 (23.1% vs. 34.3%, p<0.001) and the proportion of patients who were employed was larger in 2012 (8.2% vs. 10.2%, p=0.302). Also, in 2012, more patients received Level 1 medical care rather than health insurance (27.9% vs. 35.3%, p=0.007) and the number of patients with registered mental disability increased (27.7% vs. 52.6%, p<0.001). From 2008 to 2012, the number of patients diagnosed with other disorders besides psychotic disorders increased (15.5% vs. 22.9%, p=0.007). Also, more patients tended to receive medical treatment from private mental clinics (38.6% vs. 58.1%, p<0.001), and to be administered with atypical antipsychotics rather than conventional antipsychotics (58.6% vs. 80.4%, p=0.022). Conclusion This study suggests that many characteristics of the patients registered in a community mental health center have been gradually changed. The patients registered in 2012 were likely to be diagnosed with other disorders besides psychotic disorders and to get more atypical antipsychotics compared to patients registered in 2008. This study would contribute to finding out the proper roles and functions of mental health centers, and, as a result, the mental health centers could be able to provide better quality of service to their registered patients.