| 摘要 |
[Objectives] To systematically analyze the epidemiological characteristics and influencing factors associated with a cohort of 3 273 rural patients diagnosed with mental disorders in Zhushan County, Hubei Province and explore an integrated management path that is applicable to rural areas. [Methods] A cross-sectional survey, in conjunction with a retrospective cohort analysis, was conducted. The samples were obtained from the National Management Information System for Severe Mental Disorders (2020-2024), and all registered rural patients in Zhushan County were included through cluster sampling. All participants provided informed consent, and the study received approval from the Ethics Committee of the Zhushan County Mental Health Center. Diagnoses were made in accordance with the International Classification of Diseases, 10th Revision (ICD-10). The research utilized a self-developed socio-ecological scale, which was validated through two rounds of the Delphi method conducted by an expert group, yielding a Cronbach’s α of 0.82. The data were collected by trained investigators who conducted household visits. The data entry process involved double entry by two individuals to ensure accuracy for system review. Statistical analysis was performed using SPSS 26.0, employing the chi-square (χ2) test and logistic regression models for analysis. [Results] Schizophrenia was identified as the predominant disorder, affecting 68.4% of the patient population, followed by bipolar disorder, which accounted for 18.8%. Notably, individuals aged over 60 years constituted 40.36% of the sample. Furthermore, the poverty rate within this population was alarmingly high at 87.87%, while the illiteracy rate stood at 41.37%. The treatment experienced a significant delay, with a median duration of 14.2 months. Additionally, there was a substantial gap in standardized treatment, measured at 23.59%. The family care function was found to be inadequate, particularly for families lacking guardianship capacity, which was reported at 11.31%. An analysis of the underlying causes indicates that social structural imbalances (such as left-behind children and marital breakdown), along with economic poverty and insufficient educational opportunities, were critical risk factors contributing to these issues. The development of a model that integrates dynamic screening, full-chain intervention, and collaborative management is beneficial for fostering the efficient and systematic advancement of the rural mental health system. [Conclusions] Patients with mental disorders residing in rural areas face dual vulnerabilities. Therefore, it is essential to implement integrated management that encompasses early screening, standardized treatment, family support, and policy assistance. It is recommended that these elements should be integrated into the framework for local health policy development to enhance equitable access to mental health services and to provide psychological support for rural revitalization efforts. |
