路透社纽约健康消息-美国精神病医院里的病人患肺结核、肝炎或艾滋病的风险比普通人群高。
在1997至1999年间对美国一所精神病院650多名男女住院病人所作的调查发现，精神病患者乙型肝炎的发病率是普通人群的4-5倍，丙型肝炎的发病率为普通人群的12倍。而且这种风险性似乎还在增加，1997年只有不到20%的病人患丙型肝炎，但到了1999年则上升到30%。肝炎是由病毒感染引起, 特别是丙型肝炎，能导致肝硬化和肝癌。
研究人员还发现，超过20%的精神病患者的结核菌素试验为阳性，是全美发病率的4倍；HIV发病率估计约为3%, 至少是普通人群的9倍。值得注意的是，精神病患者身在医院却只有不到 20%的人受到常规医生检查。
哈佛医学院的精神病学讲师及波士顿埃里克·林德曼精神卫生中心的精神病主治医生珀尔博士在加利福尼亚棕榈泉召开的精神病医学年会上报告了调查结果。他对精神病患者中有如此高的感染率感到吃惊，更好的检测和治疗手段应该对对精神性疾病是有帮助的。他认为应该对这些疾病进行治疗，而且预防方面应该对药物滥用多下点功夫。
即使知道他们是瘾君子，这些病人可能也没检测HIV和肝炎，而共用针头会极大地增加HIV和肝炎的感染风险。珀尔说：“有些人无论以前是否做过检测，都应该再接受检测，比如那些有滥用药物史的人。因此，从总体上说来，我们需要把医生组织起来对慢性精神病人进行保健。这些人都有健康问题，因而，建立一个预防体系使之成为精神卫生系统的一部份而不被独立出来是有好处的。”
Mentally Ill Patients at Risk for HIV, TB And Hepatitis
NEW YORK (Reuters Health) - Patients in psychiatric hospitals are at greater risk of tuberculosis, hepatitis or HIV compared with people in the general population, researchers report.
In a study of more than 650 men and women admitted to a psychiatric hospital between 1997 and 1999, the patients were 4-5 times as likely to have hepatitis B and 12 times as likely to have hepatitis C as those in the general public.
What‘s more, the risk seemed to be increasing. Just under 20% of patients were infected with hepatitis C in 1997 while 30% of patients in 1999 had the disease. Hepatitis is a viral infection of the liver that, in the case of hepatitis C, can lead to cirrhosis and liver cancer.
The researchers found over 20% of the patients tested positive for tuberculosis--4 times the estimated rate in the US. And the rate of HIV among the psychiatric patients was estimated to be about 3%, at least 9 times that of the general population.
``It was interesting that these patients who are directly involved in the medical system have very poor medical care--and less than 20% have regular medical doctors that they see,‘‘ said study lead author Dr. W. F. Pirl, an instructor in psychiatry at Harvard Medical School and an attending psychiatrist at Eric Lindemann Mental Health Center (ELMHC) in Boston. He reported the findings this week at the annual meeting of the Academy of Psychosomatic Medicine, in Palm Springs, California.
Pirl told Reuters Health that he was surprised by the high infection rates in the patients. Better testing and treatment could help the mentally ill, Pirl said.
``Treatments are available for these diseases. And I think prevention efforts need to give more attention to substance abuse treatment.‘‘ he said.
Such patients may not get tested for HIV or hepatitis, even if they are known drug users. Sharing needles can greatly increase the risk of both HIV infection and hepatitis.
``Some of the things you would think would make people be tested--such as a history of drug abuse--were not indicative of whether or not they had been tested,‘‘ Pirl said. ``So, in general, we need to find better ways to integrate medical doctors into the care of chronic psychiatric patients. All of them have some medical issues and it would be nice to develop a system where preventative health care was part of mental health systems instead of being separate.‘‘
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