河北省保定市居民惊恐障碍患病情况分析

Epidemiological survey of panic disorder in Baoding

目的了解河北省保定市居民惊恐障碍患病率和分布特点。方法采用多阶段分层整群抽样方法,随机抽取≥18岁居民10 073人,用扩展的一般健康问卷(GHQ-12)进行心理健康水平调查;分为高、中、低危险组,以美国精神障碍诊断与统计手册-第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查病人版进行惊恐障碍的诊断;采用大体功能评定量表(GAF)评定心理、社会及职业功能受损状况。结果完成调查9 021人,惊恐障碍终生患病率为0.60%,时点患病率为0.42%;不伴广场恐惧的惊恐障碍的终生和时点患病率分别为0.55%,0.38%,伴广场恐惧的惊恐障碍分别为0.04%,0.03%。女性时点患病率为0.66%,高于男性的0.15%(P<0.01);农村时点患病率为0.46%,高于城市的0.09%(P<0.01);50～59岁患病率最高,为0.99%;惊恐障碍与其他精神障碍共病占62.5%,惊恐障碍的精神科就诊率为4.17%。结论惊恐障碍常见于农村女性,共病现象普遍,但专科就诊率低。

Objective To describe the prevalence and distribution of panic disorder 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 panic 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）. The Global Assessment Function （GAF） was used to assess the rate of psychological, social and vocational functional impairment. Results 9021 subjects completed the screening. The overaU lifetime prevalence of panic disorder was 0.60 %, and the overall current prevalence of panic disorder was 0.42 %. The lifetime and current prevalence of panic disorder without agoraphobia was 0.55 % and 0.38 %, respectively. The lifetime and current prevalence of panic disorder with agoraphobia was 0.04 % and 0.03 %, respectively. The current prevalence of panic disorder was higher in female（0.66 % ） than in male （0.15 % ） （ P 〈 0.01）, and in rural（0.46 % ） than in urban areas（0.09 % ） （ P〈 0.01）. The current prevalence was highest in the subjects aged 50 - 59 years（0.99 % ）than others. The rate of panic disorder with comorbid current other mental disorders was 62.5 %. A percentage of 4.17 % of panic disorder had sought treatment from mental health services. Conclusion Panic disorder was seen frequently in rural women and comorbidity between panic disorder and other mental disorders was common. Only a few of panic disorder had sought treatment from mental health services.