保定市躯体形式障碍的流行病学调查

Epidemiological Survey of Somatoform Disorders in Baoding City.

目的了解保定市躯体形式障碍的患病率和分布特点。方法2004年10月～2005年3月采用多阶段分层整群抽样方法随机抽取≥18周岁的人群，共10073名，用扩展的一般健康问卷（GHQ-12）将调查对象分为高、中、低危险组，采用美国精神障碍诊断标准（DSM-Ⅳ），以美国精神障碍诊断与统计手册-第四版（DSM-Ⅳ）轴Ⅰ障碍定式临床检查患者版对调查对象进行躯体形式障碍的诊断。以大体功能量表（GAF）评定患者的心理、社会和职业功能。结果9021人完成调查，躯体形式障碍的时点患病率为0．99%。（95%CI=0．79％～1．20％）．躯体化障碍0．03％、未分化的躯体形式障碍0．24％、疼痛障碍0．56％、疑病症0．18％。女性（1．43％）明显高于男性（0．13％）（P〈0．01）；40～49岁及50～59岁患病率较高（1．84％及1．55％）；与抑郁症及焦虑障碍共病49．12％；心理、社会和职业功能受损程度无或轻度50．88％、中度33．33％、重度15．79％；躯体形式障碍就诊精神科门诊为3．51％。结论躯体形式障碍在女性及中年人群（40～59岁）中患病率高，与抑郁症及焦虑障碍共病常见．其精神科服务利用率低。

Objective To stacly the current prevalence and distribution of various types of somatoform disorders in Baoding. Methods From Oct. 2004 to Mar. 2005, Stratified multi-stage cluster randomization was used to identify 10073 subjects aged 18 years or over in Baoding. An expanded version of the General Health Questionnaire （GHQ- 12） was used to identify subjects at high, moderate and low risk for having a somatoform disorder, then psychiatrists made diagnoses according to the fourth edition of Diagnostic and Statistical Manual of Mental Disorder （DSM- Ⅳ ） criteria after conducting a Structured Clinical Interview for DSM - Ⅳ -TR Axis Ⅰ Disorders-Patient Edition （SCID-I/P）. Global Assessment Function （GAF） was used to assess the rate ot psychological, social and vocational functional impairment. Results 9021 subjects completed the screening. The overall currem prevalence of somatoform disorders was 0.99 % （95 % CI= 0.79 % ～ 1.20%）. somatization disorder 0.03%, undifferentiated somatoform disorder 0.24%. pain disorder 0.56%, Hypochondriasis 0. 18%. The current prevalence of somatoform disorders was higher in female （1.43%） than in male （0.13%） （P〈0. 01）, so was in aged 40～49 years （1.84%） and aged 50～59 years （1. 55%） than others. The rate of somatoform disorders with comorbid current depression and anxiety disorders was 49.12%. The rate of psychological, social and vocational functional impairment： not or mild 50.88%, moderate 33. 33%. Severe 15.79% A percentage of 3.51% of somatoform disorders had sought treatment from mental health services. Conclusion The somatoform disorders were frequent in female and middle-aged population （40～ 59 years）, and the comorbidity between somatoform disorders and depression and anxiety disorders was common, but only a few of somatoform disorders had sought treatment from mental health services.