甘肃省天水市18岁及以上人群精神障碍流行病学调查  

Epidemiological survey of mental disorders in people aged 18 and older in Tianshui City of Gansu Province

作　　者：丁志杰[1] 王刚平[1] 裴根祥 管让成 何蕊芳 费立鹏[2] 李献云[2] 张永录[1] 汪东明[1] 洪贵子 杜鹤宇 白爱萍[1] 李刚[1] 王小全[1] 魏长礼 李宏[1] 王军[1] 

机构地区：[1]甘肃省天水市精神病医院,甘肃天水741000 [2]北京回龙观医院北京心理危机研究与干预中心,北京100096

出　　处：《中国心理卫生杂志》2010年第3期183-190,共8页Chinese Mental Health Journal

基　　金：美国中华医学基金会(Small Grants program#02-777);天水市科技攻关项目资助

摘　　要：目的:了解甘肃省天水市成年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甘肃省天水市≥18岁人群11359人为调查对象,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3组,然后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3组人群进行诊断检查。将计算出的患病率进行调整并推广至天水230万成年人口。结果:10249人完成调查,调整后精神障碍总的现患率(最近1个月)为17.90%(95%CI为15.72%～20.32%);患病率前三位分别是酒精使用障碍(3.16%)、重性抑郁障碍(2.73%)和未特定焦虑障碍(2.67%)。男性精神障碍总的现患率为15.85%,女性为20.08%;农村为17.33%,城市为20.59%;男女、农村与城市之间精神障碍总的现患率差异无统计学意义[OR(95%CI)分别为0.75(0.52～1.07)和0.81(0.57～1.15)],但酒精使用障碍男性的现患率高于女性(6.00%vs.0.14%,OR=45.59,95%CI:17.98～115.57),农村居民低于城市居民(2.43%vs.6.57%,OR=0.35,95%CI:0.15～0.85)。在有精神障碍的人群中,功能损害程度为中等到严重者占37.10%,但仅8.58%的患者曾经因心理问题在医疗机构就诊,并且仅5.29%曾经就诊于精神科。结论:甘肃省天水市精神障碍的患病率较高。酒精使用障碍和重性抑郁是特别需要关注的问题。Objective： To describe the prevalence and distribution of mental disorders among adults in the Tianshul City of Gansu Province. Methods： Using multi-stage stratified cluster sampling, 11359 subjects aged 18 or older were identified in Tianshul City. The subjects were screened with the expanded version of General Health Questionnaire （ GHQ-12） and classified as high, moderate or low risk of having a mental disorder based on the re- sults. Different proportions of the three groups were assessed with the Structured Clinical Interview for DSM-IV-TR （SCID-I/P） . Estimated prevalence rates were adjusted to represent the sampling frame of 2. 3 million adults. Restilts： Totally 10249 subjects completed the survey. The adjusted current prevalence of any mental disorder was 17. 90% （95% CI. 15.72% -20. 23% ） . The three most prevalence specific disorders were alcohol use disorder （ 3.16% ）, major depressive disorder （ 2. 73% ） and ＂ not otherwise specified ＂ （ NOS ） anxiety disorder （2. 67 % ） . The current prevalence of any mental disorder was 15.85% in males, 20.08% in females, 17.33% in rural residents, and 20. 59% in urban residents. The male-female and rural-urban differences in overall rates were not statistically significant [ OR = 0. 75, 95% CI （ 0. 52 N 1.07 ） ; 0. 81 （0. 57 - 1.15 ） ], but alcohol use disorder was significantly more prevalent in men than in women （6.00% vs. 0. 14%, OR =45.59, 95% CI： 17.98 - 115.57） and less prevalent in rural residents than urban residents 1 2.43% vs. 6.57%, OR = 0. 35, 95% CI： 0. 15 ~0. 85） . Among those with a disorder, 37.10% were moderately to severely affected due to the disorder but only 8. 58% had ever received any type of medical treatment and only 5.29% had ever received mental health treat- metaL＇ Conclusion ： The prevalence of mental disorders is high in the Tianshui City of Gansu Province. Alcohol use disorder and major depressive disorder are conditions that deserve special attention.

关 键 词：精神障碍 患病率 甘肃省 现况调查 

分 类 号：R749.01[医药卫生—神经病学与精神病学] R181.32[医药卫生—临床医学]