横浜市大センター病院精神医療センターにおける時間外救急入院の実態

Emergency Admission of Psychiatric Patients during Extra-regular Hours in the Psychiatric Center, Yokohama City University Medical Center

抄録

　横浜市大センター病院精神医療センターは，行政の精神科救急システムに応需した大学附属病院精神科である。我々は，大学附属病院精神科おける時間外（平日夜間および休日）救急入院患者の特徴を明らかにすることを目的として，精神医療センター開設以来３年間に入院した1,017名を対象とし，平日日中入院群と時間外入院群の2群に分け，患者の属性を比較検討した。その結果，時間外入院群においては，男性および非自発入院が多い，また入院日数が短く，入院回数が多かった。診断では統合失調症圏が多く，精神作用物質障害，人格障害の比率も高い。さらに，単身生活者や治療歴のない者が多く，身体拘束を要する率が高い，さらに合併症では過量服薬例が多いなどの特徴が明らかとなった。

Summary

　Psychiatric Center, Yokohama City University Medical Center is the only psychiatric department of the University hospital that participates in the governmental psychiatric emergency system, among the public Universities in Japan. The authors investigated clinical backgrounds for 290 inpatients who were admitted during extra-regular hours in the Psychiatric center over three years. The results showed that under the following categories: male, involuntarily admission, frequent hospitalization, previous non-reception of treatment, overdose, living alone, under restraint; the proportion was significantly higher and the length of stay was significantly shorter in patients with extra-regular-hour admission than in those admitted during regular hours. As to psychiatric diagnoses, schizophrenia, schizotypal and delusional disorders were most numerous among the inpatients with extra-regular hour admission. Furthermore, the proportion of mental and behavioural disorders due to psychoactive substance use and disorders of adult personality and behaviour were also higher in the inpatients with extra-regular hour admission than in those admitted during regular hours.