一所医院的神经症各亚型构成比10年变化

The variations of constituent ratio of neuroses in ten years

目的 探讨神经症各亚型构成比 1 0年前后的变化。方法 对中南大学湘雅二医院1 989年连续就诊的 1 0 0 0例神经症 ,按中国精神疾病分类方案与诊断标准第 2版的标准进行分类诊断。 1 999年在同一医院、以同一方式、使用同一诊断标准、由同一医师对连续就诊的 50 0例神经症患者分类诊断 ,并进行前后比较。结果 1 989年 ,神经症各亚型构成比依次为 :神经衰弱 ( 2 5 5% ) ,焦虑症 ( 1 6 8% ) ,癔症 ( 1 3 8% ) ,强迫症 ( 1 2 0 % ) ,抑郁性神经症 ( 1 1 2 % ) ,恐怖症 ( 6 7% ) ,疑病症 ( 1 6% )。1 0年后 ,神经衰弱的构成比下降了 1 0 7% (P <0 0 1 ) ,癔症构成比下降了 4 0 % (P <0 0 5) ,强迫症上升了 5 6% (P <0 0 1 ) ,抑郁性神经症上升了 5 2 % (P <0 0 1 ) ,恐怖症上升了 5 1 % (P <0 0 1 )。结论1 0年中该院神经症各亚型的构成比已发生变化 ,神经衰弱和癔症的构成比下降 ,焦虑症、强迫症、抑郁性神经症和恐怖症依次递升。可能的原因是精神卫生知识的普及引起患者体验和主诉的改变 ,以及社会文化因素的影响。

Objective To explore the variations of constituent ratio of neuroses in ten years Methods The percentage of subtypes in consecutive neurotic outpatients was compared between 1 000 cases in 1989 and 500 cases in 1999 in a general hospital The diagnosis was made by the same doctor according to the same diagnostic criteria in same hospital Results In 1989, the percentages of neuroses subtypes were neurasthenia (25 5%), anxiety (16 8%), hysteria (13 8%), obsessive compulsive neurosis (12 0%), depressive neurosis (11 2%), phobia (6 7%), and hypochondria (1 6%) respectively While in 1999, the percentage of neurasthenia decreased by 10 7%( P <0 01), hysteria decreased by 4%( P <0 05), whereas obsessive compulsive neurosis increased by 5 6%( P <0 01), depressive neurosis increased by 5 2% ( P <0 01), and phobia increased by 5 1%( P <0 01) Conclusion The research shows the variations of constituent ratio of neuroses during the past ten years The percentages of neurasthenia and hysteria decrease, but that of obsessive compulsive, depressive and phobic neurosis increase The changes of patients′ experiences and complaints associated with popularization of mental health knowledge and the influence of social culture factors may be the reasons of variations