摘要
目的:了解山东省≥18岁人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法,随机抽取山东省5个地级市的5个区和15个县的10个街道和30个乡镇,共计20个居委会和60个行政村,抽取≥18岁人群23987人,由精神科护士用扩展的一般健康问卷(GHQ-12)进行筛查,将调查对象分为精神障碍高、中、低危险组,然后由精神科医生用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的高、中和低危人群进行调查,作出有无精神障碍及具体诊断。结果:完成调查22718人,调整后精神障碍总的现患率(最近1个月)为19.48%(95%CI:17.48%～21.64%)。各类精神障碍现患率由高到低依次为心境障碍(5.93%)、物质使用障碍(5.62%)、焦虑障碍(5.50%)、精神病性障碍(1.28%)。男性精神障碍总的现患率(22.78%)高于女性(16.17%)(OR=1.53)。城市居民精神障碍的现患率(18.88%)与农村(19.68%)之间的差异无统计学意义。最常见的精神障碍依次为酒精使用障碍(5.55%)、心境恶劣障碍(1.99%)、重性抑郁障碍(1.50%)和精神分裂症(1.12%)。有精神障碍者中仅10.53%曾因心理问题在医疗机构就诊,但仅7.69%曾在精神科就诊。结论:精神卫生问题,特别是酒精使用障碍、重性抑郁障碍、心境恶劣障碍和精神分裂症,已成为山东省突出的公共卫生问题。
Objective： To determine the prevalence and distribution of mental disorders in adults 18 years of age and older in Shandong Province. Methods： Stratified multistage cluster randomization was used to identify 23987 individuals ≥ 18 years of age from 20 urban neighborhoods （ from 10 sub-districts in 5 urban districts ） and 60 rural villages （ from 30 rural townships in 15 counties ） from 5 prefects of the Shandong Province. Subjects were classified as high, moderate or low risk of having a mental disorder based on an expanded version of the General Health Questionnaire （ GHQ ） （ as administered by psychiatric nurses ） and then psychiatrists determined their diag- noses by administering the Structured Clinical Interview for DSM-IV （ SCID ） to different proportions of the high-, moderate-, and low-risk subjects. Results： Among the 22718 who completed the screening, the prevalence of any current mental disorder was 19. 48% （95% CI： 17. 48% ~21.64% ） . The prevalence rates of diagnostic groups of disorders were as follows： mood disorders （ 5. 93% ）, substance use disorders （ 5.62% ）, anxiety disorders （5.50% ）, and psychotic disorders （ 1.28% ） . The prevalence of any mental disorder was higher in males than in females （22.78% vs. 16. 17%, OR = 1.53） . There was no significant difference in the prevalence of any mental disorder between urban and rural residents （ 18.88% vs. 19. 68% ） . The current prevalence rates of the most com- mon specific disorders were as follows： 5.55% （ alcohol use disorder）, 1.99% （ dysthymia）, 1.50% （ major depressive disorder） and 1.12% （ schizophrenia） . Only 10. 53% of persons with a mental disorder had ever re- ceived any type of medical treatment for psychological problems and only 7. 69% had ever received treatment from a mental health professional. Conclusion： Mental health issues, particularly alcohol use disorders, major depression, dysthymia and schizophrenia, are a/ready prominent public health problems in Shandong Province.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2010年第3期161-167,182,共8页
Chinese Mental Health Journal
基金
山东省医学科研基金(2005HZ074)
美国中华医学基金会(Small Grants program#02-777)
关键词
精神障碍
患病率
山东省
现况调查
mental disorder
prevalence
Shandong Province
cross-sectional survey
作者简介
通信作者张敬悬E-mail：jingxuanzhang@126．com
费立鹏E-mail：phillipschina@yahoo．com
