浙江省人群心理障碍状况及相关因素分析

A multilevel cross-sectional study of mental disorder in community settings in Zhejiang province

目的探讨浙江省社区一般人群心理障碍水平及其影响冈素，为相关决策和干预提供依据。方法利用浙江省15岁以上人群精神病流行病学调查数据，对14632名调查对象的相关变量拟合包括县（市）、乡镇（街道）、村（居委会）和个体等4个水平的多水平模型；心理障碍评定采用一般健康问卷（GHQ-12）。结果浙江省社区人群心理障碍平均得分为（1．54±2．15），低于广州、重庆、太原、杭州等4个城市的平均水平（U=11．08，19〈0．01）；浙江省社区心理障碍在县（市）水平具有聚集性（X^2=3．94，P〈0．05），组内相关系数P=0．043；心理障碍相关因素还有年龄、婚姻状况、居住方式、受教育年数、职业、年家庭人均收入等，并发现随着家庭人均收入的增加，社区人群的心理障碍会减轻。结论浙江省社区人群心理障碍水平较低，且存在着县（市）地域集聚性；离婚、丧偶、离退休、无业或失业和低收入人群需要莺点关沣。

Objective To investigate the prevalence of mental disorder through the 12-item general health questionnaire （GHQ-12） survey and its related factors in community settings in Zhejiang Province. Methods A muti-level model was analyzed using data of 14 632 respondents nested in counties （ cities ） , townships （ urban districts ） , villages （ urban neighborhoods ） from the epidemiological survey of mental illnesses above 15 years old. Results The mean score measured by GHQ-12 was （ 1.54 ±2. 15 ） , which was lower than that of samples from four cities of Guangzhou, Chongqing, Taiyuan and Hangzhou（ U = 11.08 ,P 〈 0. 01 ）. The mental disorder clustered within county （city） level,which represented 4. 3% （ X2 = 3.94, P 〈 0.05 ） of the total variance including four levels. After controlling for the county level, the mental disorder was associated with age, marital status, residency patterns, education, occupation and household incoming. In particular, it was reported that higher household incoming was significantly associated with better mental disorder among population in community settings. Conclusion The prevalence of mental disorder clustered at the county （city） level is relatively lower with vulnerable groups including divorced, widowed, unemployed, retired, lower-income ones in community settings in Zhejiang Province.