山东省18岁及以上人群精神障碍流行病学调查  

An epidemiological survey of mental disorders among people aged 18 and above in Shandong Province

作　　者：王汝展[1] 张敬悬[1] 王延祜[1] 王灿[1] 陈修哲[1] 米国琳[1] 陈旭[1] 程小菁[1] 王丽娜[1] 胡丽丽[1] 谷灵犀 郑士全[2] 董兰[3] 王立钢[4] 陈莉 李武[6] 刘燕花 朱君 王艳梅 温庆华 李小鹏 张玉胜[12] 侯宗银 张秀茹 张廷侠[15] 郭素美 杨秀成 Wang Ruzhan;Zhang Jingxuan;Wang Yanhu;Wang Can;Chen Xiuzhe;Mi Guolin;Chen Xu;Cheng Xiaojing;Wang Lina;Hu Lili;Gu Lingxi;Zheng Shiquan;Dong Lan;Wang Ligang;Chen Li;Li Wu;Liu Yanhua;Zhu Jun;Wang Yanmei;Wen Qinghua;Li Xiaopeng;Zhang Yusheng;Hou Zongyin;Zhang Xiuru;Zhang Tingxia;Guo Sumei;Yang Xiucheng(Shandong Mental Health Center,Jinan 250014,China;Linyi Mental Health Center,Linyi 276000,China;Weifang Mental Health Center,Weifang 261000,China;Qingdao Mental Health Center,Qingdao 266034,China;Heze Municipal 3rd People′s Hospital,Heze 274031,China;Jining Mental Hospital,Jining 272051,China;Yantai Psychological Rehabilitation Hospital,Yantai 265200,China;Jinan No.2 Mental Health Center,Jinan 250100,China;Liaocheng the Fourth People′s Hospital,Liaocheng 252000,China;Dezhou the Second People's Hospital,Dezhou 253000,China;ZiBo Mental Health Center,ZiBo 255100,China;Binzhou People′s Hospital,Binzhou 256600,China;Zaozhuang Mental Health Center,Zaozhuang 277103,China;Weihai Municipal Third Hospital,Weihai 264205,China;Rizhao Mental Health Center,Rizhao 276800,China;Dongying Center for Disease Control and Prevention,Dongying 257091,China;Jinan Yingcheng Rongjun Hospital,Jinan 271100,China)

机构地区：[1]山东省精神卫生中心,济南250014 [2]临沂市精神卫生中心,276000 [3]潍坊市精神卫生中心,261000 [4]青岛市精神卫生中心,266034 [5]菏泽市第三人民医院,274031 [6]济宁市精神病防治院,272051 [7]烟台市心理康复医院,265200 [8]济南市第二精神卫生中心,250100 [9]聊城市第四人民医院,252000 [10]德州市第二人民医院,253000 [11]淄博市精神卫生中心,255100 [12]滨州市人民医院,256600 [13]枣庄市精神卫生中心,277103 [14]威海市立第三医院,264205 [15]日照市精神卫生中心,276800 [16]东营市疾病预防控制中心,257091 [17]济南市嬴城荣军医院,271100

出　　处：《中华精神科杂志》2021年第2期138-146,共9页Chinese Journal of Psychiatry

基　　金：山东省科技发展计划项目(2014GSF118002)。

摘　　要：目的调查山东省18岁及以上人群精神障碍的患病率及其分布特点。方法于2015年在山东省49个县(市、区)开展精神障碍流行病学调查,采用多阶段分层整群抽样方法,抽取山东省≥18岁人群28 000人,利用修订的一般健康问卷进行筛查,将调查对象分为精神障碍高危和低危人群,采用DSM-Ⅳ、SCID-Ⅰ/P或MMSE对高危人群进行疾病诊断,随机抽取10%的低危人群进行有无精神障碍的诊断。计算患病率并根据研究设计和抽样人口的特征调整患病率和95%的可信区间。采用χ^(2)检验和Fisher确切概率法对组间患病率差异进行比较。结果完成调查27 489人,调整后精神障碍患病率为17.46% (95%CI 17.02%~17.89%)。各类精神障碍中患病率排在前五位的分别是物质使用障碍(5.29%)、心境障碍(4.47%)、焦虑障碍(4.46%)、智力及缘于躯体和物质的障碍(1.91%)和精神病性障碍(1.12%),其中最常见的是酒精使用障碍(5.27%)和重性抑郁障碍(2.14%)。男性精神障碍患病率高于女性(23.37%与13.89%;χ^(2)=408.91,P<0.01)。农村居民精神障碍的患病率与城市居民之间的差异无统计学意义(17.69%与17.20%;χ^(2)=1.05,P=0.305)。26.12%(1 047/4 008)的精神障碍患者有中等到严重的功能损害,仅有10.98%(428/3 898)曾经寻求过专业帮助。结论山东省18岁及以上人群精神障碍患病率与国内同类研究结果基本一致,男性高于女性,城乡无差异;常见的精神障碍为酒精使用障碍、重性抑郁障碍、未特定焦虑障碍、未特定抑郁障碍。Objective This study aims to investigate the prevalence and distribution characteristics of mental disorders among people aged 18 and above in Shandong Province.Methods In 2015,an epidemiological survey was carried out to investigate the patterns of mental disorders in 49 counties of Shandong Province.A total of 28000 individuals aged 18 years or older were selected using the multistage stratified cluster sampling method.All these participants were classified as at a high or low risk of mental disorders according to the assessment results of the revised version of the General Health Questionnaire(GHQ).The diagnosis of mental disorders was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual,Forth edition(DSM-Ⅳ)axis I or MMSE.All participants at high risk of mental disorders were evaluated using DSM-Ⅳor MMSE to confirm the psychiatric diagnoses,while 10%of participants at low risk of mental disorders were randomly selected to be evaluated.The prevalence and its 95%confidence interval of mental disorders were adjusted according to study design and sociodemographic characteristics of the sample.The between-group differences of prevalence were compared using chi-square tests or Fisher′s exact tests as appropriately.Results A total of 27489 individuals completed survey.The adjusted prevalence of any mental disorder was 17.46%(95%CI 17.02%-17.89%).The five most prevalent mental disorder spectrums were substance use disorders(5.29%),mood disorders(4.47%),anxiety disorders(4.46%),intellectual and mental disorders due to physical or substance(1.91%),and psychotic disorders(1.12%).The most common mental disorders were alcohol use disorder(5.27%)and major depressive disorder(2.14%).The prevalence of mental disorders in men was higher than that in women(23.37%vs.13.89%;χ2=408.91,P<0.01).There was no significant difference in the prevalence of mental disorders between rural residents and urban residents(17.69%vs.17.20%;χ²=1.05,P=0.305).Of participants with mental disorders,26.12%(10

关 键 词：精神障碍 患病率 现况调查 

分 类 号：R749[医药卫生—神经病学与精神病学]