河北省抑郁症的流行病学调查

Epidemiological survey of depression in Hebei province

目的:了解河北省抑郁症的患病率和分布特点。方法:采用多阶段分层整群抽样方法随机抽取≥18周岁的人群16 088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4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查患者版(SCID-I/P)对调查对象进行抑郁症的诊断。心理、社会及职业功能评定采用大体功能评定量表(GAF)。结果:14 408人完成调查,抑郁症的终生患病率为0.62%(95%CI=0.46%～0.78%),时点患病率为0.54%(95%CI=0.39%～0.69%)。时点患病率:女性高于男性(P<0.01);30～39岁、40～49岁、50～59岁患病率较高。Logistic回归分析结果:女性、分居/离婚、低收入增加抑郁症的患病危险性。心理、社会及职业功能受损程度:重度57.41%,中度35.19%,无或轻度7.41%。抑郁症的精神科门诊就诊率为35.56%,住院率28.89%。结论:抑郁症是一类患病率较高的精神障碍,在女性及30～59岁中更常见,严重影响患者的心理、社会及职业功能,精神卫生服务利用率低。

Objective： To describe the current prevalence and distribution of depression in Hebei prov- ince. Method：Stratified muhi-stage cluster randomization was used to identify 16 088 subjects aged 18 years and over in Hebei. An expanded version of the general health questionnaire （GHQ-12 ）was used to identify sub- jects at high, moderate and low risk for having depression, psychiatrists then 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 impairment of psychological, social and vocational functioning. Results：A total of 14 408 subjects completed the screening. The lifetime prevalence of depression was 0.62% （ 95% CI = 0.46% - 0.78% ）,and the current prevalence of psychotic disorders was 0.54% （95% CI = 0.39% -0.69% ）. The current prevalence of depression was higher in female than in male（ P 〈0.01 ） ,and was higher in the age range of 30 - 39 than in others. Logistic regression analysis indicated that female, living apart/divorce, low income were risk factors for depression. The rate of psychological, social and vocational functional impairment ： severe 57.41% ,moderate 35.19% ,not or mild 7.41%. The outpatient attendance rate was 35.56% and hospital- ization rate was 28.98% for depression in psychiatric services. Conclusion：Depression is a highly prevalent mental disorder,especial in females aged 30 to 59. Psychological, social and vocational functioning can be impaired seriously. The patients with depression have low rate of mental health service utilization.