上海市精神卫生专科医院门诊患者人格病理现况调查  

A cross-sectional survey on personality disorder in mental disorder outpatients in Shanghai

作　　者：张天宏[1] 肖泽萍[1] 王兰兰[1] 戴云飞 张海音[1] 仇剑签 陶明毅 王振[1] 王虓 俞峻翰 吴艳茹[1] 蒋文晖 

机构地区：[1]上海交通大学医学院附属精神卫生中心,200030

出　　处：《中华流行病学杂志》2010年第8期933-937,共5页Chinese Journal of Epidemiology

基　　金：国家高技术研究发展计划（863计划）（2007AA02Z420）;上海市科委重点科技攻关项目（074119520）;上海市优秀学科带头人计划项目（08XD14036）

摘　　要：目的 调查上海市精神卫生专科医院门诊就诊者人格病理的分布及其相关因素.方法 采用系统抽样法,在上海市精神卫生中心设抽样点,对就诊于精神科门诊和心理咨询门诊的3075例就诊者进行随机抽查.以DSM-Ⅳ为诊断标准,以人格障碍诊断问卷（PDQ-4＋）为人格障碍筛查工具进行初筛,对筛查阳性者应用轴Ⅱ人格障碍临床访谈（SCID-Ⅱ）进行临床诊断,采用logistic回归模型分析与人格障碍相关的危险因素.结果 在所有就诊者中,自评的人格障碍检出率为71.3%,经临床医生结构式访谈后确认符合人格障碍诊断标准的共计982例（31.9%）.低年龄群体（OR=1.8,95%CI：1.5～2.1）、未婚或离异者（OR=1.6,95%CI：1.4～1.9）、心理咨询门诊患者（OR=1.2,95%CI：1.1～1.3）、心境障碍和神经症性障碍患者（OR=1.7,95%CI：1.4～2.0）中符合人格障碍诊断标准的患者比例更高.logistic回归分析提示：年龄小、童年时并非由父母抚养以及病前性格内向是人格障碍的相关危险因素.结论 人格障碍在精神卫生服务的对象中并不少见,特别是在就诊于心理咨询的心境障碍、神经症性障碍患者中,提示需要对该群体的人格病理进行积极的识别和干预.Objective To study the prevalence and risk factors for personality disorder （PD）outpatients attending in for psychiatric and psychological counseling in Shanghai. Methods 3075 subjects were sampled by systematic sampling method from outpatients in psycho-counseling clinics and psychiatric clinics in Shanghai Mental Health Center. Based on DSM- Ⅳ criteria, personality disorders were assessed by both questionnaires （personality diagnostic questionnaire, PDQ-4＋） and interviews （structured clinical interview for DSM- Ⅳ Axis Ⅱ , SCID- Ⅱ ）. Logistic regression analysis was performed to determine the significant independent contributor to PD. Results 71.3% of the outpatients were found having pathological personality by using questionnaire of self rating PD scale. 982 outpatients （31.9%） met criteria for at least one personality disorder by using structured clinical interview. Younger age （OR= 1.8, 95% CI： 1.5-2.1 ）, single or divorced （OR = 1.6, 95%CI：1.4-1.9）, psychological counseling outpatients （OR=1.2, 95%CI： 1.1-1.3）, mood and outpatients with neurosis disorders （OR = 1.7, 95%CI： 1.4-2.0） were more frequently assigned as personality disorders. Data from logistic regression analysis showed that patients of tender age, not nurtured and raised by their parents, with introvert characters were related risk factors of PD. Conclusion High prevalence rate of PD was found in this sample of Chinese outpatients, especially in thosepsychological counseling outpatients with mood or neurosis disorders. More attention should be paid to the recognition and intervention of PD in outpatients with mental disorders.

关 键 词：人格障碍 心境障碍 神经症性障碍 现况调查 门诊患者 

分 类 号：R195[医药卫生—卫生统计学]