山东省莱芜市15岁及以上人群精神障碍流行病学调查

Epidemiological survey of mental disorders among people aged 15 and over in Laiwu city of Shandong Province

目的:了解山东省莱芜市精神障碍流行病学状况。方法:采用初级单位含量比例分层、整群、随机抽样方法对≥15岁的莱芜市城乡居民进行扩展的一般健康问卷(GHQ-12)评分,并根据评分(≥4分、1~3分、0分)分为精神障碍的高、中、低危险组;采用《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(SCID-I/P)对100%的高危组、40%的中危组及10%的低危组人群进行精神障碍诊断。结果:共有6 314位城乡居民完成调查,高、中、低危险组分别有1 033、395、4 886人;精神障碍时点总患病率为13.87%,终身患病率16.45%。精神障碍患病率依次为焦虑障碍3.91%(247例)其中创伤及应激相关障碍1.14%(72例)、心境障碍3.10%(196例)、酒精依赖2.33%(147例)、精神分裂症1.47%(93例)、躯体疾病所致精神障碍1.10%(70例)、精神发育迟滞0.97%(61例)、痴呆0.03%(21例)、躯体形式障碍0.65%(41例);其中心境障碍和焦虑障碍的患病率女性明显高于男性,酒精依赖患病率男性显著高于女性,农村高于城市;创伤及应激相关障碍和躯体形式障碍患病率较高。结论:莱芜市精神障碍流行病学调查发现:心境障碍、精神分裂症患病率较高,是国家公共卫生工作防治的重点;以酒精依赖、焦虑障碍,创伤及应激相关障碍、躯体形式障碍等轻型精神障碍患病率也较高,值得重视。

Objective： To investigate the mental disorder prevalence and distribution characteristics in Laiwu city of Shandong Province. Method： Using the primary unit of content proportional stratified, cluster and random sampling method, the ≥ 15 year old urban and rural residents were assessed by the expansion of the general health questionnaire （GHQ-12）. Accoding to GHQ-12 scores they were divided into the high （ ≥4）, medium （1-3） and low（0） risk of mental disorders group. Using the diagnostic and statistical manual of mental disorders 4th edition version axis I disorders pattern in patients with clinical examination （SCID-I/P） 100%, 40% and 10% menbers in high, medium and low risk groups respectively were diagnosed of mental disorders. Results：A total of 6 314 people completed the survey. The high,medium and low risk group were 1 033,395, 4 886 cases, respectively. The total mental disorder point prevalence rate was 13.87%, the lifetime prevalence rate was 16.45%. The prevalence rate of psychiatric disorders in order were as follows ： anxiety disorder 3.91% （247 cases） which included posttraumatic stress disorder 1.14% （72 cases）, mood disorder 3.10% （ 196 cases） ,alcohol dependence 2.33% （ 147 cases） ,schizophrenia 1.47% （93 cases） ,mental disorder due to general medical condition 1.10% （70 cases）, mental retardation 0.97% （61 cases） ,dementia 0.03% （21 cases）, so- matoform disorders 0.65% （41 cases） ;the mood disorders and anxiety disorders prevalence rates were signifi- cantly higher in female,prevalence rate of alcohol dependence was significantly higher in men and in rural areas than women and in urban areas. Trauma and stress-related disorders and somatoform disorders prevalence rate were higher. Conclusion： Epidemiological investigation in Laiwu city of mental disorders indicated that：the prevalence of severe mental disorders such as the mood disorders and schizophrenia are higher which are the focus of national public health prevention and treatment; the alcohol dependence, anxiety disorders, trauma and stress-related disorders, somatoform disorders and other mild mental disorders prevalence are also high,which is worth attention.