青海省18岁及以上人群精神障碍流行病学调查

Epidemiological survey of mental disorders in persons aged 18 and older in Qinghai Province

目的:了解青海省成年人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法抽取青海省≥18岁人群12001人,用扩展的一般健康问卷(GHQ-12)筛查,将调查对象分为精神障碍高、中、低危险组,然后用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的三组人群进行诊断检查。将计算出的患病率调整并推广至青海省370万成年人口。结果:11178人完成了调查。调整后精神障碍总的现患率(最近1个月)为18.04%,95%可信区间(95%CI)为15.99%～20.28%;患病率前三位的分别是酒精使用障碍(12.24%)、广泛性焦虑障碍(1.40%)和心境恶劣障碍(1.13%)。男性精神障碍总的现患率及酒精使用障碍的现患率均明显高于女性[(27.92%vs.7.47%,23.39%vs.0.30%;OR(95%CI)=4.80(3.81～6.05),OR(95%CI)=100.22(35.07～286.38)];农村与城市居民精神障碍总的患病率差异无统计学意义(18.33%vs.17.08%,OR=1.09,95%CI:0.76～1.56)。在有精神障碍的人群中,功能损害程度为中等到严重者占15.48%,但仅2.59%有精神障碍者曾经因心理问题在医疗机构就诊,仅0.94%曾在精神科就诊。结论:青海省酒精使用障碍是特别需要关注的公共卫生问题。

Objective ： To describe the prevalence and distribution of mental disorders among adults in Qing- hai Province. Methods： Using multi-stage stratified cluster sampling, 12, 001 individuals ≥18 years were selected in Qinghai Province. The subjects were screened with the expanded version of General Health Questionnaire （ GHQ- 12 ） and classified as high, moderate or low risk of having a mental illness. Different proportions of the three groups were assessed with the Structured Clinical Interview for DSM-IV-TR （ SCID-I/P ） . The estimated prevalence was adjusted to be representative of the 3.7 million adults in Qinghai. Results： Totally 11, 178 individuals completed the screening. The 1-month overall prevalence of any mental disorder was 18.04% （95% CI： 15.99% - 20. 28%） . The three most common diagnoses were alcohol abuse （ 12. 24%）, generalized anxiety disorder （ 1.40% ）, and dysthmia （ I. 13% ） . The overall prevalence of current mental disorders was much higher in males than in females （ 27. 92% vs. 7.47%, OR =4. 80, 95% CI： 3. 81 -6. 05 ）, primarily because of the much higher rate of alcohol use disorders in males （ 23. 39% vs. 0. 30%, OR = 100. 22, 95% CI： 35.07 - 286. 38 ） . There was no significant difference in rural and urban overall rates （ 18. 33% vs. 17.08%, OR = 1.09, 95% CI： 0. 76 - 1.56 ） . Among persons with a mental disorder, 15.48% had moderate to severe disability due to the disorder, but only 2.59% had ever sought medical help for psychological problems and only 0. 94% had ever seen a mental health professional. Conclusion： Alcohol use disorders are important public health problems that need special attention in Qinghai.