山东省≥18岁人群精神分裂症患病率、生命质量、应对方式及社会功能现状研究

A cross-sectional study about prevalence of schizophrenia,life qualities,coping styles and social functions in people above 18 years old in Shandong Province

目的了解山东省≥18岁人群精神分裂症患病率及患者生命质量、应对方式及社会功能现状。方法采用多阶段分层整群抽样方法,随机抽取山东省5个地级市的5个区和15个县的10个街道和30个乡镇,共计20个居委会和60个行政村,共抽取≥18岁人群23 987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疾病诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的高、中和低危人群进行调查,诊断有无精神分裂症并评估其生命质量、应对方式和社会功能。结果完成调查22 718人(94.62%),按照高、中、低危组中各自符合SCID诊断的比例及课题设计特征进行患病率调整后精神分裂症总的现患率为1.12%,不同性别、城乡之间患病率无明显差异(P>0.05)。经功能大体评定量表(GAF)评估精神分裂症致残率为92.52%,患者积极应对方式和生命质量明显差(P<0.01)。结论山东省≥18岁人群精神分裂症患病率和致残率较高。患者的生命质量明显低于常人,积极应对方式不足。

Objective To determine the prevalence of schizophrenia, life qualities, coping styles and social functions in population above 18 years old in Shandong Province. Methods Stratified multistage cluster randomization was used to identify 23 987 individuals above 18 years old dwelled in 20 urban neighborhood committees （selected from 10 sub-districts in 5 urban districts） and 60 rural villages （ selected from 30 rural townships in 15 counties） distributed in 5 prefectures of the Shandong Province. Subjects were classified as high, moderate or low risk of having a mental disorder based on an expanded version of the General Health Questionnaire （GHQ） administered by psychiatric nurses, and then investigated by psychiatrists by using the Structured Clinical Interview for DSM-IV （SCID） to determined whether the individual had schizophrenia and to evaluate their life qualities, coping styles and social functions. Results Among the 22 718 individuals （94.62%） who completed the screening, the prevalence of schizophrenia was 1.12% after being adjusted by different diagnostic rates in different risk sub-groups in accordance with SCID and the design characteristics of the study. There was no significant urban-rural difference or gender difference in schizophrenic prevalence （P 〉 0.05 ）. The disability rate of schizophrenia assessed by GAF was 92.52%. There was significant differences in the positive coping-styles and life qualities between individuals with schizophrenia and normal people （P 〈 0.01 ）. Conclusion The prevalence and disability rate of schizophrenia are high in peoples above 18 years old in Shandong Province. Life qualities and positive coping-styles in those individuals with schizophrenia were worse when compared with normals.