일 도시 보건소 등록 정신장애인 실태조사

A Survey of State on Mentally III Patients Registered at the Public Health Office in a City

This study was performed to investigate the general characteristics, present state and psychosocial function of mentally ill patients and family, registered at the Public Health Office in a City and to utilize the basic data to develop the community mental health program for chronic mentally ill patients in the community. The subjects were 73 mentally ill patients(51 home-resident, 22 in-patients) who registrated at N public health office in a city. The data were collected from July 1 to September 30, 2001 , and analysed by number, percentage, mean and standard deviation. The result of this study were as follows : 1) 69.9% of the subjects were the home-resident and 30.1 % in-patients in mental health facilities. 61.1 % were males, 38.9% females, 85.3% single, separate, divorced and bereaved. 52.1 % were over high school graduate. 2) 64.4% of the subjects had religion, 53.0% were the medicare 1. 94.5% had no occupation. 92.3% no monthly income. 79.6% thought that their income was not very enough or not enough. 3) 90.4% of the subjects have had psychiatric treatment. The onset age of treatment was 28.1 and the average duration of treatment was 12.2 years. 4) 46.3% of the subjects had a suicidal idea. 25.8% a suicidal attempt, and 20.8% family history of schizophrenia 5) 77.5% of the subjects had the diagnosis of the schizophrenia, 8.5% epilepsy, 5.6% alcohol problem or mental retardation and 2.8% mood disorder. 6) 35.7% of the subjects had psychotic symptoms such as auditory hallucination, visual hallucination and delusion, 18.6% mood change, 15.7% sleep disorder, 8.6% bizzare behavior, 5.7% anxiety and depression, and 4.2% disorder of impulse control and violence 7) 93.2% of the subjects have psychiatric treatment, 47.8% treated voluntarily. 43.8% have side effect. 68.7% of patients and 66.7% of care giver have not knowledge of medication. 8) Care givers of subjects were parents(51.4%), brother or sister(14.3%) and children (7.2%). 9) GAF (Global Assessment Function Scale) (1) 23.2% of subjects were the score of 60-51 , 21.7% score of 50-41 , 18.8% score of 40-31 , 2.9% score of 90-81 and 1.4% score of 20-11. (2) 45.2% were mentally disabled 3th grade (GAF score 51-60), 34.3% mentally disabled 1st grade (GAF score 40 below) and 20.6% mentally disabled 2nd grade (GAF score 41-50 below). Average GAF score of the subjects was 49.4. Most of chronic mentally ill patients have had difficulties in social interaction, communication and daily living activity because of long alienation with family and society. Although acute symptoms may disappear by short-term hospital treatment, otherchronic symptoms remain for a long time. If the patients have only drug therapy, they may have many difficulties in psychosocial rehabilitation because of deficiency in skills of self care, interpersonal relationship, vocation and leisure. Therefore, in order to the prevent the chronicity and facilitate the social rehabilitation of the chronic mentally ill patients, more comprehensive community mental health services must be performed in the hospital and community.