山东省18岁及以上人群精神障碍流行病学调查  

Epidemiological survey of mental disorders in persons aged 18 years and older in Shandong Province

作　　者：张敬悬[1] 卢传华[1] 唐济生[1] 邱慧敏[1] 刘兰芬[1] 王松波[1] 王爱祯[1] 张天亮[1] 费立鹏[2] 李献云[2] 张韶东 江永华 赵长英[5] 胡伯文 曹学义[7] 张艳[1] 高春霓[1] 

机构地区：[1]山东省精神卫生中心,山东济南250014 [2]北京回龙观医院北京心理危机研究与干预中心,北京100096 [3]烟台市心理康复医院,山东莱阳265200 [4]枣庄市第二人民医院,山东枣庄277103 [5]济南市精神卫生中心,山东济南250032 [6]聊城市第四人民医院,山东聊城252000 [7]潍坊市精神卫生中心,山东昌乐262400

出　　处：《中国心理卫生杂志》2010年第3期161-167,182,共8页Chinese Mental Health Journal

基　　金：山东省医学科研基金(2005HZ074);美国中华医学基金会(Small Grants program#02-777)

摘　　要：目的:了解山东省≥18岁人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法,随机抽取山东省5个地级市的5个区和15个县的10个街道和30个乡镇,共计20个居委会和60个行政村,抽取≥18岁人群23987人,由精神科护士用扩展的一般健康问卷(GHQ-12)进行筛查,将调查对象分为精神障碍高、中、低危险组,然后由精神科医生用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的高、中和低危人群进行调查,作出有无精神障碍及具体诊断。结果:完成调查22718人,调整后精神障碍总的现患率(最近1个月)为19.48%(95%CI:17.48%～21.64%)。各类精神障碍现患率由高到低依次为心境障碍(5.93%)、物质使用障碍(5.62%)、焦虑障碍(5.50%)、精神病性障碍(1.28%)。男性精神障碍总的现患率(22.78%)高于女性(16.17%)(OR=1.53)。城市居民精神障碍的现患率(18.88%)与农村(19.68%)之间的差异无统计学意义。最常见的精神障碍依次为酒精使用障碍(5.55%)、心境恶劣障碍(1.99%)、重性抑郁障碍(1.50%)和精神分裂症(1.12%)。有精神障碍者中仅10.53%曾因心理问题在医疗机构就诊,但仅7.69%曾在精神科就诊。结论:精神卫生问题,特别是酒精使用障碍、重性抑郁障碍、心境恶劣障碍和精神分裂症,已成为山东省突出的公共卫生问题。Objective： To determine the prevalence and distribution of mental disorders in adults 18 years of age and older in Shandong Province. Methods： Stratified multistage cluster randomization was used to identify 23987 individuals ≥ 18 years of age from 20 urban neighborhoods （ from 10 sub-districts in 5 urban districts ） and 60 rural villages （ from 30 rural townships in 15 counties ） from 5 prefects of the Shandong Province. Subjects were classified as high, moderate or low risk of having a mental disorder based on an expanded version of the General Health Questionnaire （ GHQ ） （ as administered by psychiatric nurses ） and then psychiatrists determined their diag- noses by administering the Structured Clinical Interview for DSM-IV （ SCID ） to different proportions of the high-, moderate-, and low-risk subjects. Results： Among the 22718 who completed the screening, the prevalence of any current mental disorder was 19. 48% （95% CI： 17. 48% ~21.64% ） . The prevalence rates of diagnostic groups of disorders were as follows： mood disorders （ 5. 93% ）, substance use disorders （ 5.62% ）, anxiety disorders （5.50% ）, and psychotic disorders （ 1.28% ） . The prevalence of any mental disorder was higher in males than in females （22.78% vs. 16. 17%, OR = 1.53） . There was no significant difference in the prevalence of any mental disorder between urban and rural residents （ 18.88% vs. 19. 68% ） . The current prevalence rates of the most com- mon specific disorders were as follows： 5.55% （ alcohol use disorder）, 1.99% （ dysthymia）, 1.50% （ major depressive disorder） and 1.12% （ schizophrenia） . Only 10. 53% of persons with a mental disorder had ever re- ceived any type of medical treatment for psychological problems and only 7. 69% had ever received treatment from a mental health professional. Conclusion： Mental health issues, particularly alcohol use disorders, major depression, dysthymia and schizophrenia, are a/ready prominent public health problems

关 键 词：精神障碍 患病率 山东省 现况调查 

分 类 号：R749.041[医药卫生—神经病学与精神病学] R181.32[医药卫生—临床医学]