湖南省≥15岁居民双相情感障碍流行病学调查  

Prevalence of bipolar disorder among residents aged 15 years and older in Hunan province: a cross-sectional study

作　　者：李茂生 邬志美[1] 李小松 刘学军[1] 罗邦安[1] 肖鹏飞 王东欣 LI Mao-sheng;WU Zhi-mei;LI Xiao-song(Psychiatry Department,Human Province No.2 People＇s Hospital,Brain Hospital of Hunan Province,Changsha,Hunan Province 410000,China)

机构地区：[1]湖南省脑科医院湖南省第二人民医院精神科,长沙410000

出　　处：《中国公共卫生》2018年第8期1065-1069,共5页Chinese Journal of Public Health

基　　金：湖南省卫生和计划生育委员会课题(B2015-103)

摘　　要：目的全面了解湖南省≥15岁人群双相情感障碍的患病情况及分布特点。方法在2015年2—6月,采用多阶段、系统、整群、随机抽样方法在湖南省123个县(市、区)随机抽取≥15岁居民,以增补后的一般健康问卷12项(GHQ-2)和重性精神疾病异常行为线索调查问卷作为筛选工具,以美国精神障碍诊断与统计手册–第四版(DSM-Ⅳ-TR)轴Ⅰ障碍定式临床检查(SCID-I/P)作为诊断工具,对湖南省双相情感障碍的患病率及分布特征、影响因素和患病特点等进行分析。结果本次调查第一阶段完成调查户口中≥15岁摸底人口为84 242人,实际共72 999人(86.65%)完成增补后的一般健康问卷12项(GHQ-12)及异常行为线索调查问卷。经过第一阶段筛查,共5 869人进入第二阶段调查。第二阶段调查发现双相情感障碍患者75例(双相Ⅰ型43例,双相Ⅱ型27例,其他双相5例),时点患病率为1.03‰(95%CI=0.79‰~1.26‰),终生患病率为1.49‰(95%CI=0.75‰~2.18‰)。双相情感障碍患者以情感症状为主要表现的59例,占78.67%,其中有16例(21.33%)伴有精神病性症状。城市和农村患病率分别为1.03‰(37例)、1.02‰(38例),差异无统计学意义(χ2=0.00,P>0.05);男性和女性患病率分别为0.99‰(36例)、1.06‰(39例),差异无统计学意义(χ2=0.074,P>0.05);年龄分布:45~59岁患病率(0.471‰)最高,患病27例(占比36.00%);其次是≥60岁的患病率(0.421‰),患病25例(占比33.33%)。双相障碍患者的文化程度相对较低,小学及以下文化程度64例(85.33%),以农民33例(44.00%)、失业或无业的20例(26.67%);婚姻状况以已婚(29例,38.67%)、离异(23例,占30%)为主,其次是未婚(19例,25.33%)。结论此次调查基本掌握了湖南省双相情感障碍的患病情况、流行特点、分布规律及患病特点,为制订精神卫生相关政策提供了比较全面客观的依据。Objective To investigate the prevalence and distribution characteristics of bipolar disorder among the residents aged 15 years and older in Hunan province for promoting mental health among the residents. Methods We conducted a survey on bipolar disorder among permanent residents aged ≥ 15 years recruited with stratified multistage cluster random sampling in 123 counties or districts of Hunan province during February and June 2015. The modified 12-Item General Health Questionnaire（GHQ-12） and clue investigation were used in mental disorder screening and then Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision [DSM-IV-TR]Axis I Disorders, Research Version, Patient Edition（SCID-I/P）-Chinese version was adopted in the diagnosis of bipolar disorder among the participants with mental illness. The prevalence, distribution characteristics and influencing factors of bipolar disorder among the participants were analyzed. Results Of the 84 242 residents in the study, 72 999（86.65%）completed the screening test, of which, 5 869 were interviewed by psychiatrists with SCID-I/P; and finally, 75 participants were identified with bipolar disorder（43 with phase I, 27 phase II, and 5 with other phase of bipolar disorder; 59 [78.67%]mainly having emotional symptoms and 16 [21.33%] having psychotic symptoms）. Among the 72 999 participants completed the survey, the point and lifetime prevalence rate of bipolar disorder were 1.03‰（95% confidence interval[95% CI]： 0.79‰ – 1.26‰） and 1.49‰（95% CI： 0.75‰ – 2.18‰）; there were no significant differences in the point prevalence rate between male and female participants（0.99‰ vs. 1.06‰, χ2 = 0.074; P 0.05） and between urban and rural participants（1.03‰ vs. 1.02‰, χ2 0.01; P 0.05）. The highest time prevalence rate（0.471‰） was observed among the participant aged 45 – 59 years, followed by that（0.421‰） among those aged 60 years and older. Of the bipolar d

关 键 词：双相情感障碍 心境障碍 流行病学调查 患病率 湖南省 

分 类 号：R195.4[医药卫生—卫生统计学]