汶川地震后重灾区人群重性抑郁障碍流行病学调查

Epidemiological investigation on major depressive disorder in the most heavily damaged areas from Wenchuan earthquake in 2008

目的了解中同汶川5·12地震后重灾区居民的重性抑郁障碍患病率、患者的人151学和社会文化特征及患病相关危险因素。方法采用分层整群抽样方法随机抽取≥15岁人群14503人，以一般健康问卷12项（GHQ-12）为筛选工具，采用美国精神障碍诊断与统计手册第4版（DSM-IV）轴I障碍定式临床检查版（SCID—I／P）为调查诊断工具。结果重性抑郁障碍现患180例，时点患病率为1．27％，终生患病率为1．36％；女性（DR=1．56，95％CI：1．136～2．143，P〈0．05）、合并躯体疾病（OR=4．02，95％CI：2．75～5．90，P〈0．05）、地震中受伤（OR=3．29，95％CI：1．92～5．65，P〈0．05）、财产损失（其中10万～20万元OR：2．09，95％（21：1．18～3．69，P〈0．05；〉20万元OR=2．54，95％CI：1．38～4．68，P〈0．05）、家人去世或失踪（OR=3．79，95％CI：2．08～6．89，P〈0．05）以及中年人群（OR=231，95％CI：1．38～3．86，P〈0．05）为危险因素。有职业为保护性因素（OR=0．60，95％CI：0．43～0．83，P〈0．05）。结论重性抑郁障碍是目前地震灾区较为多发的精神疾病。

Objective To assess the prevalence, demographic characteristics, risk factors and protective factors on major depression disorder （MDD） among the affected people in the epicenter, 7 months after the 2008-earthquake in Wenchuan, China. Methods Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan, Beichuan county and Qingchuan county, Sichuan province. We used the general health questionnaire （GHQ-12） as the screening instrument, and the structured clinical interview for DSM- IV -TR axis I disorder-patient edition （SCID- I/P） as the tool for diagnosis. Results There were 180 persons diagnosed as MDD with other 13 asymptomatic ones. The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%. Risk factors were including： being female （OR= 1.56,95%CI：1.136 - 2.143, P〈0.05 ）, co-morbidity with somatic diseases （OR=4.02,95%CI： 2.75- 5.90, P〈 0.05 ）, wounded in the earthquake （OR = 3.29,95% CI： 1.92-5.65, P〈 0.05 ）, property loss up to 10 000-20 000 Yuan （0R=2.09, 95%CI： 1.18-3.69, P〈0.05）, property loss up to 〉20 000 Yuan （OR=2.54, 95%CI： 1.38-4.68, P〈0.05）, death or missing of family members （OR=3.79,95%CI： 2.08-6.89, P〈0.05 ） and in middle-age （OR=2.31,95%CI： 1.38-3.86, P〈0.05 ） etc. Having had a job seemed to be a protective factor （OR=0.60, 95% CI： 0.43-0.83, P〈0.05）. Conclusion Major depressive disorder appeared to be a common psychiatric disease in these quake-stricken areas, that causing serious problems. Sustained follow-up and care provided to the affected people in these areas were of extreme importance.