浙江省15岁及以上人群精神疾病流行病学调查  

Epidemiological survey of mental illnesses in the people aged 15 and older in Zhejiang Province,China

作　　者：石其昌[1] 章健民[1] 徐方忠[1] 费立鹏[2] 许毅[3] 傅永利[1] 顾卫[1] 周夏江[1] 王淑敏[1] 张滢[1] 俞敏[4] 

机构地区：[1]浙江省立同德医院精神卫生办公室,杭州310012 [2]北京市回龙观医院北京心理危机研究与预防中心 [3]浙江大学医学院附属第一医院精神卫生科 [4]浙江省疾病预防控制中心

出　　处：《中华预防医学杂志》2005年第4期229-236,共8页Chinese Journal of Preventive Medicine

基　　金：浙江省WHO/卫生部精神卫生项目

摘　　要：目的了解浙江省15岁以上人群各类精神疾病的时点患病率和分布特点,为制定全省精神卫生规划提供科学依据。方法2001年9至12月采用多阶段分层整群抽样方法随机抽取14个县(市)、70个乡镇(街道)、140个村(居委会)中15000名≥15岁的人为调查对象,由精神科护士用扩展的一般健康问卷(GHQ12)将调查对象分为患精神疾病高、中、低危险组,然后由精神科医生以美国精神障碍诊断标准(DSMIV)依次对100%、40%、10%的调查对象进行定式检查(SCID),对各类精神障碍进行诊断。结果14639人完成筛选,4788人完成诊断。调整后精神疾病总时点患病率为17.3%(95%CI为16.0%～18.7%),除外各类未特定障碍后,总时点患病率下降至13.4%(12.2%～14.7%)。最常见的疾病为心境障碍(8.6%,7.9%～9.5%)、焦虑障碍(4.3%,3.6%～5.1%)和物质使用障碍(3.0%,2.4%～3.8%)。最常见的特定精神疾病为重性抑郁障碍(4.3%,3.7%～4.9%)、酒精使用障碍(2.9%,2.3%～3.7%)、心境恶劣障碍(1.6%,1.3%～1.9%)和特殊恐怖症(1.2%,0.8%～1.8%)。总患病率农村高于城市(RR=1.23,95%CI为1.11～1.37),女性略高于男性(RR=1.11,1.00～1.22)。结论精神障碍是严重影响浙江省社会经济发展的、迫切需要解决的公共卫生问题,有必要在全省范围内开展和实施全面性的精神卫生规划并定期评估其效果。Objective To describe the current prevalence and distribution of all types of mental disorders in Zhejiang Province and use this data to develop a provincial mental health plan.Methods Stratified multi-stage cluster randomization was used to identify 14 counties (cities), 70 townships (urban districts), 140 villages (urban neighborhoods) and 15 000 subjects ≥15 years of age. Psychiatric nurses used an expanded version of the General Health Questionnaire (GHQ) to identify subgroups of subjects at high, moderate and low risk of having a mental disorder, then psychiatrists determined their diagnoses by administering a structured psychiatric examination (SCID) that employs American diagnostic criteria for mental disorders (DSM-IV) to 100% of high-risk, 40% of moderate-risk and 10% of low-risk subjects.Results 14 639 subjects completed the screening and 4 788 completed the psychiatric examination. The adjusted overall current rate of mental disorders was 17.3% (95% CI=16.0%-18.7%), which dropped to 13.4% (12.2%-14.7%) if the non-specific (NOS) disorders were excluded. The most common diagnostic groups were affective disorders (8.6%, 7.9%-9.5%), anxiety disorders (4.3%, 3.6%-5.1%),and substance use disorders (3.0%, 2.4%-3.8%). The most common specific disorders were major depressive disorder (4.3%, 3.7%-4.9%), alcohol use disorder (2.9%, 2.3%-3.7%), dysthymia (1.6%, 1.3%-1.9%) and specific phobias (1.2%, 0.8%-1.8%). The overall prevalence was higher in rural than in urban areas (RR=1.23, 95% CI=1.11-1.37) and slightly higher in women than in men (RR=1.11,1.00-1.22).Conclusions Mental disorders seriously affect the social and economic development of Zhejiang Province; they are a major public health problem that urgently needs to be addressed. To do this, it is necessary to develop and implement a comprehensive province-wide mental health plan and regularly evaluate its effectiveness.

关 键 词：精神疾病 流行病学调查 浙江省 人群 时点患病率 调查对象 一般健康问卷 精神障碍 重性抑郁障碍 心境恶劣障碍 社会经济发展 公共卫生问题 卫生规划 15岁以上 2001年 精神科护士 精神科医生 科学依据 抽样方法 诊断标准 

分 类 号：R749[医药卫生—神经病学与精神病学] R595.7[医药卫生—临床医学]