Clinical stability, diagnosis and catchment area: the patients of a university-based psychiatric outpatient clinic

ABSTRACT Objective This study aimed to characterize the patients assisted at the general outpatient clinic of the Psychiatry Institute of Universidade Federal do Rio de Janeiro (IPUB-UFRJ) and to assess these patients’ clinical stability. Methods This cross-sectional study collected information using a structured questionnaire filled in by the patient’s physician. The questionnaire, specifically developed for this purpose, included sociodemographic data; the dwelling area; psychiatric diagnosis according to ICD-10; clinical stability assessment by means of five psychiatric instability criteria and the physician’s global clinical impression over the six previous months. Clinical stability was defined as a negative answer to all five pre-defined instability criteria. Results Overall, 1,447 questionnaires were filled in. The sample was composed of 824 (57%) women; with an average age of 49 years; 1,104 (76.3%) patients lived in the city of Rio de Janeiro and 343 (23.7%) lived outside the city; 983 (67.9%) patients had a severe mental disorder (SMD) diagnosis and 946 (65.3%) patients were considered stable. Statistically, the clinical stability by dwelling area did not differ. The most frequent clinical instability criterion was “exacerbation or emergence of acute manifestations of the disease”. Conclusion The major part of the patients displayed a SMD and was considered clinically stable.

摘要
目的：本研究旨在对巴西里约热内卢联邦大学精神病学研究所（IPUB-UFRJ）普通门诊接诊的患者进行特征分析，并评估其临床稳定性。
方法：本项横断面研究采用患者主治医师填写的结构化问卷收集研究数据。该问卷为本次研究专门编制，涵盖社会人口学资料、居住区域、依据ICD-10标准作出的精神疾病诊断、通过5项预设精神疾病不稳定判定标准开展的临床稳定性评估，以及主治医师对受试者近6个月临床状况的整体印象。临床稳定性被定义为对全部5项预先设定的不稳定判定标准均给出否定答复。
结果：本研究共收集到1447份问卷。样本包含824名女性患者，占比57%；平均年龄49岁；1104例（76.3%）患者居住于里约热内卢市，343例（23.7%）居住于该市以外区域；983例（67.9%）患者被诊断为重度精神障碍（Severe Mental Disorder, SMD），946例（65.3%）被评定为临床稳定。统计学分析显示，不同居住区域患者的临床稳定性无显著差异。最常见的临床不稳定判定标准为“疾病急性症状加重或新发”。
结论：大部分受试者被诊断为重度精神障碍且临床状态稳定。