中国精神疾病流行病学调查进展的分析和评价

Methodology improvements in China mental disorder epidemiological surveys from 1950 to 2008

目的 分析我国精神疾病流行病学调查（以下简称流调）的进展和不足.方法 采用文献计量学方法,计算机检索英文数据库（PubMed,EMBASE）和中文数据库[中国知网（CNKI）中文期刊全文数据库,中国生物医学文献光盘数据库和万方数据库]中1950年1月1日至2008年12月22日的流调报告,并手工检索〈中华神经精神科杂志〉（1955年至1996年）的流调报告,以时间为线索描述研究进展,用流行病学现况调查设计方法学要点（研究设计、样本量估计、抽样方法、诊断评价工具、现场质控等）评价研究的方法学质量.结果 （1）共有39个流调纳入评价（儿童青少年流调仅1个）;（2）国内流调发展可划分为：1958年至1981年、1982年至2000年和2001年至今3个阶段;（3）第1阶段流调均为未采用诊断评价工具的普查;第2阶段与第3阶段相比：0.0%（0/16）和25.0%（4/16）的研究报告了样本量估计方法、0.0%（0/20）和12.5%（2/16）的研究报告了知情同意、5.0%（1/20）和31.2%（5/16）的研究报告了现场质控措施.结论 流调方法学水平在提高,但总体水平参差不齐;需要重视流调方法学研究,并有必要开展儿童青少年精神疾病流调.

Objective To assess the advances of methodology in China mental disorder epidemiological surveys from 1950 to 2008. Methods Using bibliometrics approach, a number of English （PubMed, EMBASE） and Chinese databases （Chinese National Knowledge Infrastructure, Chinese Biomedical Database Disc and Wanfang Database）, related reports and literature reviews＇ references list were comprehensively searched between Jan. 1, 1950 and Dec. 22, 2008, Chinese Journal of Neurology ＆ Psychiatry （from 1955 to 1996） was also searched by hand, and the large-scale regional mental disorder epidemiological surveys were collected. Taking time as clue, the methodological characteristics in study design, sample size calculation, sampling method, diagnostic evaluation tool, field work quality control,etc., was analyzed. Results Totally 39 surveys, including 1 children and adolescents mental disorder epidemiological survey, were searched out. All the surveys from 1958 to 1981 were censuses without diagnostic evaluation tool. In the surveys from 1982 to 2000 compared to the ones from 2001 to 2008, 0（0/16） and 25.0% （4/16） of the studies reported the sample size estimation method, 0.0% （0/20） and 12.5% （2/16） of them reported the implementation of informed consent, 5.0% （1/20） and 31.2% （5/16）of them reported the adoption of field work quality control approaches, respectively. Conclusions The methodological quality has been increasing in recent years, but the overall methodological level is irregular and uneven. More attention must be attached to the methodological design. There is a pressing need to conduct mental disorder epidemiological survey among children and adolescents.