A cross-sectional analysis of registry data of severe mental disorders in Fuzhou, China: current status and prospects.

Objective: To investigate the proportion of registered cases relative to size, distribution characteristics, medication status, and management status of patients diagnosed with severe mental disorders (SMD) in Fuzhou. The medication status and management status were compared between patients in urban and non-urban areas to provide scientific evidence for improving SMD care, control, and treatment in primary health care institutions.

Methods: Data (case types, demographic data, distribution data, medication status, and management status, etc.) of patients diagnosed with SMD in 12 districts, counties, and prefectures in the urban and non-urban areas of Fuzhou City were collected from October 2017 to September 2018. Three distributions (population, local, and districts/counties) were used to describe the proportion of registered cases relative to size and clinical characteristics of diagnosed SMD. Chi squared (χ2) test was used to compare the severity in urban and non-urban areas.

Results: A total of 30,362 registered SMD patients were identified in Fuzhou City of which schizophrenia accounted for the highest number of cases (26,204, 86.31%), and paranoid psychosis had the least number of cases (47, 0.15%). Moreover, approximately half of SMD patients were 18 to 44 years old (45.38%). Close to one third of patients were farmers (30.23%), had a primary school or lower education level (54.17%), were poor, with most below the poverty line (55.35%). The proportion of diagnosed SMD relative to size was highest in Minqing County (0.53%) and lowest in Mawei District (0.38%). A total of 22,989 (75.72%) of the patients were taking medications, and only 17,509 (57.67%) were taking medications regularly. Moreover, the percentage of cases taking medications and those taking medications regularly were higher in urban areas than in non-urban areas (P<0.05). A total of 3065 patients were registered for management (10.09%). The managed proportion of SMD cases was higher in the urban areas than in the non-urban areas (P < 0.05).

Conclusion: Schizophrenia is a key disease for comprehensive care and control of severe mental disorders in Fuzhou. The management of severe mental disorders should focus on poor groups with low educational backgrounds. Drug usage and management are better in urban areas than in non-urban areas, and thus management should be enhanced in non-urban areas. The medication management and case management of patients with severe mental disorders in Fuzhou need further improvements.