中国≥15岁人群精神残疾的描述性流行病学研究

Descriptive epidemiological study on mental disabilities in China

目的描述我国≥15岁人群精神残疾的流行强度和特征。方法采用描述性流行病学研究方法分析第二次全国残疾人抽样调查相关资料，计算≥15岁人群精神残疾的残疾率和构成比。结果共调查771797户2526145人，其中≥15岁多重残疾者15155人，残疾率为6．01％。；单一残疾者11501人，残疾率为4．57％。。单一精神残疾者中精神病性障碍的构成比为64．58％；心境障碍和癫痫的构成比分别为6．28％和6．27％；神经症性障碍占5．95％；痴呆占5．19％；其余精神障碍占11．74％。精神病性障碍者的生活能力和社会功能损害最严重，其次为痴呆、其他器质性障碍以及癫痫残疾者。痴呆致残最为严重，一级残疾构成比达44．89％。心境障碍和神经症性障碍所致残疾的功能损害较轻，但构成比较高。结论第二次抽样调查的精神残疾率高于第一次，精神病性障碍为精神残疾中最主要的致残疾病，痴呆是致残最严重的疾病。

Objective To describe the prevalence and characteristics of mental disabilities in China. Methods The data from the Second National Sample Survey on Disability were analyzed with descriptive epidemiological method and the overall prevalence rates of mental disabilities were statistically calculated. Results Among 2 526 145 respondents, 15 155 of them more than 15 years old were diagnosed as mental disabilities, with the prevalence rate as 6.01%o. The prevalence rate of disabilities caused only by mental disorders was 4.57%0 with 11 501 more than 15 years old. The prevalence rate of disability caused only by mental disorders was 4.67%o with 11 501 adults. Of the disability cases that exclusively caused by mental disorders, 64.58% of them were attributable to schizophrenia, schizotypal or delusional disorders, 6.28% were mood disorder, and 6.27% were epilepsy disability,followed by neurotic, stress-related and somatoform disorders （5.95%）, dementia （5.19%） , and other disabilities （less than 11.74% ）. Disabilities that attributable to schizophrenia, schizotypal and delusional disorders caused most severe impairments of functions in daily and social activities, followed by disabilities attributable to dementia, non-dementia organic mental disorder and epilepsy disability. Dementia caused the most severe grade of disability, accounted for 44.89% of all the cases. The data also showed that the disabilities attributable to mood disorder and neurotic, stress-related and somatoform disorder showed more impairments among mental disabilities. Conclusion Prevalence of mental disability in the second sample survey was higher than that of the first survey. Schizophrenia accounted for most of the mental disabilities but dementia caused the severest disability among all the cases with mental problems. As two of main causes of mental disabilities, neurosis and anxiety disorders should also be paid attention to.