厦门市不同人群心境障碍、焦虑障碍和物质使用障碍现况调查

Cross-sectional study on mood disorders,anxiety disorders and substance use disorders among different occupational populations in Xiamen city

目的了解福建省厦门市不同人群心境障碍、焦虑障碍和物质使用障碍的患病率和流行特征。方法采用多阶段分层整群随机抽样法,以扩展的一般健康问卷对厦门市12 071名≥18岁的城乡居民进行现况调查,将调查对象分为精神障碍高危、中危和低危人群,使用《美国精神障碍诊断与统计手册(第4版)轴Ⅰ障碍定式临床检查(患者版)》依次对100%高危人群、40%中危人群和10%低危人群进行诊断检查。结果厦门市心境障碍、焦虑障碍和物质使用障碍的调整后的终身患病率(调整患病率)分别为3.19%、1.46%和1.13%。无业与失业人群、学生与家庭妇女、农民与渔民为心境障碍高发人群,调整患病率分别为5.80%、5.74%、4.76%;学生与家庭妇女、无业与失业人群、农民与渔民为焦虑障碍高发人群,调整患病率分别为2.27%、2.13%、1.83%;工人与服务人员、个体户与临时工、无业与失业人群为物质使用障碍高发人群,调整患病率分别为2.19%、2.11%、1.70%。结论厦门市居民精神障碍分布呈现明显的职业特征,无业与失业人群、学生与家庭妇女人群的心境障碍和焦虑障碍高发,工人与服务人员、个体户与临时工人群的物质使用障碍患病率最高,应采取有针对性的防治措施。

Objective To describe the prevalence and distribution of mood disorders, anxiety disorders and substance use disorders among different occupational populations in Xiamen city. Methods With multi-stage stratified cluster random sampling, 12 071 subjects aged 18 years and older were identified in Xiamen City. The subjects were screened by the ex-panded version of twelve-item General Health Questionnaire and classified as high, moderate or low risk of having a mental disorder based on the results. Different proportions of the 3 groups （ 100% of the high-, 40% of the moderate-, 10% of the low-risk） were assessed with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition. Results The adjusted overall lifetime prevalence of mood disorders, anxiety disorders and substance use disorders were 3.19% , 1.46% and 1.13% , respectively. Unemployed people, students and housewives, farmers and fishermen had higher inci-dence in mood disorders, the adjusted prevalences were 5.80% , 5.74% and 4.76% , respectively. Students and house-wives, unemployed, farmers and fishermen had higher incidence in anxiety disorders, the adjusted prevalences were 2. 27%, 2. 13% and 1.83% , respectively. Whereas workers and service staffs, self-employed and temporary workers, unemployed people were frequently found in substance use disorders, the adjusted prevalences were 2. 19% , 2. 11% and 1.70%, respectively. Conclusion The observations of this study supported that the distribution of mental disorders had obvious occupational characteristics. Unemployed people, students and housewives have higher incidence in mood disorders and anxiety disorders, workers and service staffs, self-employed and temporary workers have the highest prevalence of sub-stance use disorders. Targeted prevention and control measures should be promoted among these groups.