There is a contradiction between a large population with severe mental illness and insufficient capacity to receive and treat them in China. Most of these patients long-termly live in the community, so it is essential for community health institutions to provide this population with timely and effective primary mental health services.

To analyze the characteristics of newly increased and decreased patients with severe mental illness in a community in Beijing from 2011 to 2021, so as to provide evidence for the implementation of community-based prevention and treatment of mental illnesses.

In January 2022, information of registered patients with severe mental illness (schizophrenia, bipolar disorder, schizoaffective disorder, persistent delusional disorder, mental disorders associated with epilepsy or mental retardation accompanied by mental disorders) in a community of Beijing was obtained through Beijing Municipal Mental Health Information Management System, including demographic characteristics, disease status and the status of file creation. The yearly morbidity, mortality and years of life lost (YLL) rates were calculated for years between 2011 and 2021. With the patient information up to December 31, 2010 as the baseline, the information of newly increased and deceased patients from 2011 to 2021 was counted.

From 2011 to 2021, the newly increased patients outnumbered the deceased ones, and the prevalence rate increased year by year since 2012, reaching 3.77‰ in 2021. Compared with the baseline, patients with severe mental illness in 2021 presented the following features: higher education level, a higher proportion of employers, a higher proportion of 60-year-olds and older, a lower proportion of schizophrenics, a higher proportion of patients with bipolar disorder, and a shorter duration of non-creation of files, and the differences were statistically significant (P<0.05). During the period, there were 212 newly increased patients, and most of them suffered from schizophrenia (57.08%, 121/212) or bipolar disorder (36.32%, 77/212). The age of the first onset was mostly between 19 and 45 years (65.57%, 139/212). The number of patients with 5 years or less of duration of non-creation of files was the most (40.57%, 86/212), and the average median was 8.5 (15.5) years. Among the 90 deceased cases, schizophrenics accounted for the highest percentage (86.67%, 78/90), and those aged over 60 years accounted for 74.44% (67/90). The top three causes of death were somatic disease (84.44%, 76/90), suicide (7.78%, 7/90), and accidental death (2.22%, 2/90). The YLL rate fluctuated between -0.250‰ and 1.436‰ during the period.

The period of 2011 to 2021 witnessed more newly increased community residents with severe mental illness than deceased ones, an increased prevalence trend of severe mental illness, a shortened duration of non-creation of files, and the aged as the major deceased group, and somatic diseases as the major cause of death. Targeted measures should be taken to cope with the above changes.

目前我国存在严重精神障碍患病人群庞大与收治能力不足之间的矛盾，多数患者长期生活在社区，因此由社区卫生服务机构为该人群提供及时、有效的初级精神卫生服务具有重要意义。

了解2011—2021年北京市某社区新增与死亡严重精神障碍患者特征，为开展社区精神疾病防治提供参考。

于2022年1月，通过北京市精神卫生信息管理系统获取某社区6类（精神分裂症、双相情感障碍、分裂情感障碍、持久性妄想性障碍、癫痫所致精神障碍、精神发育迟滞伴发精神障碍）在册严重精神障碍患者的信息，包括人口学特征、疾病情况和建档情况。计算2011—2021年历年的患病率、死亡率、生命损失年（YLL）率。以截至2010-12-31的患者信息为基础数据，统计2011—2021年历年新增与死亡患者信息。

2011—2021年历年新增患者例数多于死亡患者例数，患病率从2012年开始逐年上升，至2021年达3.77‰。与基线时相比，2021年社区严重精神障碍患者的受教育程度更高，处于在职状态者占比更高，≥60岁老年患者占比增加，精神分裂症患者占比降低、双相情感障碍患者占比升高，未建档期缩短，差异有统计学意义（P<0.05）。2011—2021年新增患者212例：疾病类型以精神分裂症（57.08%，121/212）和双相情感障碍（36.32%，77/212）居多，发病年龄集中在19~45岁（65.57%，139/212），未建档期以≤5年者居多（40.57%，86/212），中位未建档期为8.5（15.5）年。2011—2021年死亡患者共90例，精神分裂症患者死亡最多（86.67%，78/90），死亡年龄>60岁者占74.44%（67/90），死亡原因排在前3位的分别为躯体疾病（84.44%，76/90）、自杀（7.78%，7/90）、意外死亡（2.22%，2/90）。2011—2021年的YLL率为-0.250‰~1.436‰。

2011—2021年社区严重精神障碍患者新增多于死亡，患病率呈上升趋势，新增患者未建档期缩短，死亡患者以老龄躯体疾病为主，应采取针对性措施应对前述变化。