Abstract: Objective　To investigate the difference between local and non-local residents with severe mental disorders under management living in urban areas，providing evidence for scientific management of such patients in urban areas.Methods　The sample was selected from patients with severe mental disorders under management living in an urban district of Beijing in June 2016.Sociodemographic data （including hukou information） and data concerning illness status and management stemmed from the mental health information system of a mental health center in the district.Logistic regression models were used to explore the difference in management methods between Beijingers and non-Beijingers with severe mental disorders.Results　Beijingers and non-Beijingers with severe mental disorders had differences in age，educational attainment，marital status，employment status，types of severe mental illnesses，duration of suffering from the illness，current treatment status，status and methods of management as well as prevalence of developmental disabilities（P<0.05）.Logistic regression analysis suggested that educational attainment and type of hukou were significantly associated with the interview management methods（outpatient department，entering the household） for patients with severe mental disorders（P<0.05）.Conclusion　Non-Beijingers were middle-aged and young people without disability，while the number of schizophrenic patients with long course and untreated condition was less，and the number of patients with bipolar affective disorder manifested by mood change was more.Educational attainment and type of hukou were significantly associated with the interview management methods for patients with severe mental disorders.The management of patients with severe mental disorders in urban areas should focus on the characteristics of the illness and the utilization of health services to improve the management effect.

Key words: Mental disorders, Disease management, Urban area, Type of hukou, Beijing

摘要： 目的　通过比较分析北京市不同户籍接受管理的严重精神障碍患者的差异，为北京市严重精神障碍患者的科学管理提供参考依据。方法　选取2016年6月北京市某区接受管理的严重精神障碍患者进行研究，抽取精神卫生信息系统收集的患者基本信息、户籍类型、疾病情况以及管理信息。采用多因素Logistic回归分析分析精神分裂症患者接受面试管理方式（即门诊入户）的影响因素。结果　北京市户籍和非北京市户籍严重精神障碍患者年龄、受教育程度、婚姻状况、工作状况、疾病种类、病程、残疾情况、治疗情况、管理情况和管理方式比较，差异均有统计学意义（P<0.05）；多因素Logistic回归分析结果显示：受教育程度、户籍类型是精神分裂症患者的接受面试管理方式（即门诊、入户）的影响因素（P<0.05）。结论　非北京市户籍患者以非残疾的中青年（≤44岁）为主，而病程长、未治疗的精神分裂症患者较少，以心境改变为表现的双相情感障碍的患者较多。而受教育程度和户籍类型是籍精神分裂患者接受面试管理的影响因素。应根据不同户籍患者疾病特点和服务利用的特点开展管理，进一步提高严重精神障碍患者管理
效果。

关键词: 精神障碍, 疾病管理, 城市地区, 户籍类型, 北京