上海市闵行区精神障碍患者流行病学特征分析

Epidemiological characteristics of patients with mental disorders in communities of Minhang District,Shanghai

目的掌握社区精神障碍患者的流行病学特征,为社区干预提供依据。方法对上海市闵行区在册管理的精神障碍患者的流行病学特征以及精神分裂症、双相情感障碍、癫痫所致精神障碍及精神发育迟滞4种主要精神障碍患者人口学分布进行分类统计。结果截至2016年9月,闵行区在册精神障碍患者人数8 972例,时点患病率为3.53‰,男女构成比为1:1,未婚:在婚=0.97:1。医疗费用来源主要以城镇职工基本医疗保险、新型农村合作医疗和城镇居民基本医疗保险为主。文化程度以初中最多占34.6%,小学占25.1%,文盲及半文盲占18.8%,高中及专科占18.1%,本科及以上占3.4%。8 972例患者中4种主要精神障碍患者占89.1%,依次为精神分裂症4 282例,精神发育迟滞3 088例,癫痫所致精神障碍416例,双相情感障碍208例。不同诊断的精神障碍患者在性别、年龄、文化程度、婚姻状况、医疗费用和经济情况分布上均有差异。结论精神障碍尤其是精神分裂症和精神发育迟滞是社区重要公共卫生问题,不同类型精神疾患具有不同的人口学特征,在社区管理过程中应针对不同类型的精神病患不同特征采取有针对性的防治措施。

Objective To clarify the epidemiological characteristics of patients with mental disorders and provide evidence for developing effective intervention protocols in communities. Methods We characterized the epidemiological data of community-based patients with mental disorders, classified and analyzed the demographic data of schizophrenia, bipolar affective disorder, epilepsia-caused mental disorder, and mental retardation in Minhang District. Results Up to September 2016, a total of 8 972 patients with mental disorders were registered in this district, with a point prevalence of 3.53/103 and the male-to-female ratio of 1： 1. The medical expenses were mainly covered by basic medical insurance for urban workers, new rural cooperative medical system, and basic medical insurance for urban residents. The ratio of the unmarried to the married was 0.97： 1. The patients graduated from junior high school accounted for 34.6% , primary school for 25.1% , illiteracy and semi-illiteracy for 18.8% , senior high school and professional school for 18.1% , and college and above for 3.4%. Of 8 972 patients,four major disorders accounted for 89. 1% , including 4 282 schizophrenia patients, 3 088 patients with mental retardation, 416 patients with epilepsia-eaused mental disorder, and 208 patients with bipolar affective disorder. The distribution of sex, age, educational level, marriage status, medical expense, and socioeconomic status were different among the patients with mental disorders of different types. Conclusion Mental disorders especially schizophrenia and mental retardation are the major public health concerns in communities. Distinct mental disorders have different demographic characteristics and should be cared with individualized approaches in the community-based management.