辽宁省成人精神障碍流行病学调查

Prevalence of mental disorders among adult residents in Liaoning province,China

目的了解辽宁省城乡居民各类精神障碍现患率及分布特点,为制定辽宁省精神卫生规划提供客观依据。方法 2014年10月—2015年6月,采用多阶段分层整群随机抽样方法 ,在辽宁省7个地级市随机抽取24000人为研究对象,应用增补后的一般健康问卷(GHQ-12)进行筛查,分为精神障碍高、中、低危险3组,由精神科医生用美国精神障碍诊断与统计手册(DSM-IV)轴I障碍临床定式检查(SCID-I/P)依次对100%、40%和10%的3组调查对象进行诊断检查。结果有效调查19733人(82.22%),其中精神障碍的总现患率(最近一个月)为14.05%,女性12.93%,男性15.47%;城市人群13.04%,农村人群14.83%;30~50岁及>60岁年龄段是多种精神障碍的高发年龄;心境障碍(4.57%)、焦虑障碍(3.63%)、物质使用障碍(2.29%)是3个最常见的疾病诊断组,酒精使用障碍(2.29%)、抑郁障碍(2.28%)是患病率最高的2种精神障碍。结论辽宁省精神障碍的现患率较高,精神问题已经成为关注的公共精神问题。

Objective To describe current prevalence and distribution of all types of mental disorders among adult residents in Liaoning province and to provide evidences for developing a provincial mental health plan. Methods Strati- fied multistage cluster randomization was used to recruit 24 000 urban and rural residents aged 18 years and above in 7 municipalities. All the participants were screened with the expanded version of the General Health Questionnaire （GHQ-12） and assigned into one of the three groups at high, moderate, and low risk of having a mental disorder. Then, based on the criterion of Diagnostic and Statistical Manual of Mental Disorders-4th Edition（DSM-IV） ,the diagnostic examination was performed by psychiatrists among 100% ,40% ,and 10% of the participants of the groups with high, moderate, and low risk of having a mental disorder using Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition （ SCID- I/P）. The survey was carried out between October 2014 and June 2015. Results Of the residents, 82.22% （ 19 733） completed the survey. The adjusted current （ in the previous one month） prevalence rate of any mental disorder was 14. 05% （95% confidence interval：13. 57% -15. 47% ）. The overall prevalence rate of mental disorders was higher in the males （ 15.46% ） than in the females （ 12. 93% ）, and slightly higher in rural participants （ 14. 83% ） than in urban participants （ 13.04% ）. Among all the participants, the three most common mental disorders were affective disorder （4. 57% ） ,anxiety disorder （3.63%） ,and substance use disorder （2. 88% ）. Alcohol use disorder （2. 86% ） and major depression disorder （2. 39% ） were the most prevalent specific mental disorders. Conclusion The current prevalence rate of mental disorders is relatively high among adult residents and mental disorder has become a major public health problem in Liaoning province.