烟台市18岁及以上人群精神疾病流行病学调查

Epidemiological survey of mental disorders in adults aged 18 years and above in Yantai

目的了解烟台市18岁及以上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,随机抽取烟台市的1个区和3个县的2个街道和6个乡镇,共计4个居委会和12个行政村,共抽取18岁及以上人群4 800人,由精神科护士用扩展的一般健康问卷(GHQ-12)进行筛查,将调查对象分为精神障碍高、中、低危险组,然后由精神科医生用美国《精神障碍诊断与统计手册第四版》(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的高、中和低危人群进行调查,做出有无精神障碍及具体诊断。结果完成调查4 458人,调整后精神障碍总的现患率(最近一个月)为18.57%。心境障碍(6.84%)、焦虑障碍(5.59%)和酒精使用障碍(5.41%)分列前三位。男性精神障碍现患率明显高于女性(21.80%vs 16.18%,P<0.01)。农村精神障碍的现患率明显高于城市(19.58%vs 14.92%,P<0.01)。结论烟台市精神疾病的患病率较高,心境障碍、焦虑障碍和酒精使用障碍已成为突出的公共卫生问题。

Objective To determine the prevalence and distribution of mental disorders in adults aged 18 years and above in Yantai city. Methods Multistage stratified cluster randomization was used to identify 4800 individuals aged 18 years and above in 4 neighborhood committees （randomly selected from 2 sub-districts in 1 urban districts） and 12 rural villages （randomly selected from 6 rural townships in 3 counties）. Subjects were classified as high, moderate or low risk of having a mental disorder based on an expanded version of General Health Questionnaire （ GHQ-12 ） administered by psychiatric nurses, and then were diagnosed by psychiatrists by using the Structured Clinical Interview for DSM-IV （SCID）. Results Among 4458 who completed the screening, the current prevalence of mental disorder was 18.57% and the top three were mood disorder （6.84%）, anxiety disorder （5.59%）, alcohol use disorder （5.41%）. The prevalence of mental disorders was significantly higher in males than that in females （21.80% vs. 16.18%, P 〈 0.01 ） , and was significantly higher in rural residents than that in urban residents （ 19.58% vs. 14.92% , P 〈0.01 ）. Conclusion The prevalence of mental disorders in Yantai is high. Mental disorders, especially mood disorder, anxiety disorder and alcohol use disorder have become prominent public health problems.