重庆市990名农村老年人精神卫生状况及其影响因素分析  

Mental health status of 990 rural community elderly and its associated factors in Chongqing

作　　者：张代江[1] 谭小林[1] 程雪[1] 汪波[1] 周建初[1] 曹国兴[1] 陈黎明[1] 刘涛[1] 李远[1] 

机构地区：[1]重庆市精神卫生中心老年科,401147

出　　处：《重庆医学》2014年第7期775-778,共4页Chongqing medicine

基　　金：重庆市卫生局医学科研计划资助项目(2010-2-336)

摘　　要：目的探讨重庆市农村老年人的精神卫生状况及其影响因素。方法采用多级分层随机抽样方法,抽取60岁及以上的重庆市农村常住老年人口990名进行调查。以筛查量表筛选出可疑精神病阳性者,并根据《中国精神障碍分类与诊断标准》(第3版)及《美国精神障碍诊断与统计手册》(第4版)进行复查诊断;对无精神病者,应用症状自评量表(SCL-90)、纽芬兰幸福度量表、社会支持评定量表、修订艾森克人格问卷简式量表中国版进行心理测试。结果 (1)990名老年人中,精神病筛选阳性率为24.04%(238/990),现患病率为19.43%(193/990),分别诊断为乙醇所致精神障碍(11.4%)、器质性精神障碍(5.96%)、心境障碍和其他精神病性障碍(2.12%)。(2)797名非精神病老年人中,一般心理健康问题检出率为17.17%(124/722),其中家庭组的检出率及SCL-90总分均显著高于机构组[检出率20.24%vs.3.73%,χ2=20.90,P=0.000;SCL-90总分(109.14±11.77)分vs.(100.59±7.87)分,t=-8.01,P=0.000]。(3)SCL-90总分显示,女性、无配偶、有负性生活事件、独居、有慢性病、收入较差的老年人心理健康状况较差,差异有统计学意义(P<0.05)。(4)农村老年人SCL-90总分与幸福度总分、正性情感、正性体验、社会支持及各维度、内外向呈显著负相关,与负性情感、负性体验、神经质、精神质呈显著正相关,差异均有统计学意义(P<0.05)。(5)负性情感、精神质、慢性病、养老方式、婚姻状况、是否独居、社会支持总分、神经质进入回归方程,决定系数R2=0.346。结论 1/3以上的农村老年人有精神卫生问题,养老方式对老年人心理健康的影响最明显;防治乙醇所致精神障碍、转变养老方式仍然是当前农村老年精神卫生工作的重点。Objective To explore mental health status of rural elderly and itassociated factors of mental health in Chongqing. Methods Totally 990 rural community residents aged 60 years or more were selected by multi-stage stratified random sampling and investigate with self-designed screening inventory to pick out suspect psychosis,then diagnose according to DSM iV and CCMD-3. For no psychosis,investigated with symptom self-assessment scale（SCL-90）, newfoundland happiness scale, social support rating scale,eysenck personality questionnaire short form scale （China）. Results （1） In 990 the elderly, the screening positive rate was 24.04 % （238/990）, prevalence rate was 19.43 % （193/990）. Diagnosis were mental disorders caused by acohol（ 11.4 % ）, mental dis- orders due to physical dysfuction（5.96%）,mood disorders and other psychiatric disorders（2. 12%）. （2）17. 17%（124/722） rural elderly had psychological problems in 799 non-mental health elderty,in which the screening positive rate and total scores of SCL-90 in family group were significant higher than the institute group screening positive rate （screening positive 20.24 % vs. 3.73 %, X2 = 20.90,P=0. 000;total scores（ 109.14± 11.77） vs. （100.59±7. 87）,t= - 8. 01,P= 0. 000）. （3）According to the total score of SCL-90,those female, without spouse, negative life events, live alone, with chronic disease, with little income had worse mental health（P〈0.05）. （4）Total score of SCL-90 in rural elderly was significant negatively correlated with total score of happiness, posi- tive emotions, positive experience, all dimensions of social support and internal and external, the score was significant positively cor- related with negative emotions, negative experience, neuroticism, psychoticism, the differences were statistically significant （P 〈0.05）. （5）Negative emotional,mental quality, chronic diseases, endowment way, marital status, whether to live alone, total score of social support,neurotic entered the regre

关 键 词：精神卫生 老年人 精神病 心理健康 

分 类 号：R749[医药卫生—神经病学与精神病学]