2012-2018年重庆市精神障碍死亡率及疾病负担变化趋势

Changing trends in the mortality rate and disease burden of mental disorder in Chongqing Municipality, 2012-2018

目的了解重庆市精神障碍死亡率与疾病负担变化趋势,为开展精神障碍防治工作提供建议。方法收集2012-2018年重庆市精神障碍死亡个案,分析死亡率、标化死亡率、早死导致寿命损失年率、平均寿命损失年和年度变化百分比(annual percent change, APC)。不同性别、不同地区间死亡率的比较采用χ^2检验,率的趋势变化采用APC,对其检验采用t检验。结果重庆市精神障碍死亡率与标化死亡率分别由2012年的1.86/10万、1.63/10万上升至2018年的2.66/10万、2.04/10万,APC分别为6.61%与4.29%,死亡率变化趋势差异有统计学意义(t=3.00,P=0.030)。各年度男女精神障碍死亡率差异均无统计学意义(P>0.05)。城市与农村精神障碍死亡率比较发现,2014年与2016年农村死亡率高于城市,2018年城市高于农村,差异均有统计学意义(P<0.05)。精神障碍死亡率随年龄的增长而上升。重庆市精神障碍早死所致的寿命损失年率(years of life due to premature death, YLL)波动于0.47‰~0.58‰,平均寿命损失年(averageyears of life lost due to premature death,AYLL),由2012年的26.08年下降至2018年的17.83年,APC为-6.67%,变化趋势有统计学意义(t=7.09,P=0.001)。结论 2012-2018年重庆市精神障碍死亡率呈上升的趋势,高于其它省市精神障碍死亡率,平均寿命损失年呈下降的趋势,精神障碍纳入社区管理成效明显。

Objective To understand the changing trends in the mortality rate and disease burden of mental disorder in Chongqing Municipality, and to provide suggestions for conducting mental disorder prevention and control. Methods Death cases of mental disorder in Chongqing from 2012 to 2018 were collected. The mortality rate, age-standardized mortality rate(ASMR), rate regarding years of life lost due to premature death(YLL), average years of life lost due to premature death(AYLL) and annual percent of change(APC) were analyzed. The differences in the mortality rates between different genders as well as between urban and rural areas were compared by Chi-square test. Trend changes of the mortality rates were analyzed by APC and tested by t test. Results The mortality rate and ASMR of mental disorder in Chongqing Municipality increased from 1.86/100,000 and 1.63/100,000 in 2012 to 2.66/100,000 and 2.04/100,000 in 2018. The APC on the mortality rate and ASMR was 6.61% and 4.29%, respectively. The changing trends of the mortality rate showed statistically significantly differences(t=3.00, P=0.030). No statistically significant differences were found in the mortality rates for male and female mental disorder among different years(P>0.05). A comparison of the mortality rates of mental disorder between urban and rural areas revealed that the mortality rates in rural area in 2014 and 2016 were both higher than those in urban area(P<0.05), but the mortality rate in urban area in 2018 was higher than that in rural area,with a statistically significant difference( P < 0. 05). The mortality rate of mental disorder increased with age. The rates regarding YLL on mental disorder in Chongqing Municipality fluctuated between0. 47‰ and 0.58‰,AYLL on mental disorder decreased from 26.08 years in 2012 to 17.83 years in 2018,and APC was-6.67%,showing statistically significant differences in the changing trends( t = 7. 09,P = 0. 001). Conclusions The mortality rates of mental disorder in Chongqing Municipality from 2012 to 2018 showed an upward tendency,which were higher than those of other provinces or cities,but AYLL on mental disorder presented a downward tendency. The effect of community management of mental disorder is obviously.