湖南省15岁以上人群六种重性精神疾病调查及影响因素研究  

Investigation on Six Severe Mental Illness in Population over 15 Years Old in Hunan Province and Their Influencing Factors

作　　者：周晓璇[1] 李彬 盛晴 王东欣 刘学军[1] 肖鹏飞 刘秀兰[1] ZHOU Xiaoxuan;LI Bin;SHENG Qing;WANG Dongxin;LIU Xuejun;XIAO Pengfei;LIU Xiulan(Department of Psychiatric,Brain Hospital of Hunan Province,Changsha 410017,China;Clinical Medical College,Hunan University of Chinese Medicine,Changsha 410017,China)

机构地区：[1]湖南省脑科医院精神科,长沙410017 [2]湖南中医药大学临床医学院,长沙410017

出　　处：《医学综述》2021年第10期2020-2024,共5页Medical Recapitulate

基　　金：国家科技支撑计划课题(2015BAI13B02);湖南省科技计划项目(2018SK7002);湖南省脑科医院A类重点院级课题(2018A03)。

摘　　要：目的调查湖南省15岁以上人群重性精神疾病的患病风险水平及分布特征,探讨其影响因素。方法采用筛查和线索调查方法,即根据全国精神疾病最低现患率估计初始样本量为10万人,对全省123个县区的15岁以上人群采用多阶段系统整群抽样,以增补后的12项一般健康问卷及重性精神疾病异常行为线索作为筛选工具,以DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查作为工具进行诊断。分两阶段对被抽取的住户进行调查,调查了一般社会人口学特征,患病率及终身患病率,性别、年龄、地区及文化程度等分布特点,进一步进行病史、医疗服务利用、家庭社会影响和就医保障等方面的调查。采用二元Logistic回归分析对重性精神疾病患病的影响因素。结果在纳入结果统计的72 999人中,患重性精神障碍者720人,全省重性精神疾病的时点患病率为9.35‰(95%CI 8.130‰~10.750‰),其中精神分裂症的时点患病率最高,为6.50‰(95%CI 5.660‰~7.450‰);终身患病率为10.100‰(95%CI 8.780‰~11.620‰)。不同文化程度、不同职业类型、不同婚姻状况人群的重性精神疾病患病率比较差异有统计学意义(P <0.05),其中文盲、无业或失业和离异人群患病率较高,分别为16.950‰(95%CI 11.530‰~24.850‰)、18.220‰(95%CI 14.050‰~23.150‰)、28.610‰(95%CI18.710‰~43.520‰)。二元Logistic回归模型分析显示,年龄、文化程度、职业类型、婚姻状况是重性精神疾病患病的影响因素(P <0.05)。结论 15~44岁以下中青年患病率高,患病人口平均年龄仍较高,但老龄患者患病率下降。文化程度、职业类型、婚姻状况人群的患病也有差异,而这可能是重性精神疾病本身给患者带来各种不利影响的结果。Objective To investigate the risk level and distribution characteristics of severe mental illness among people over 15 years old in Hunan province,and to explore the influencing factors. Methods Screening and clue survey methods were used,and the initial sample size was estimated to be 100 000 people according to the lowest prevalence rate of mental illness in China. A multi-stage cluster sampling method was used for the population over 15 years old in 123 counties and districts of the province. 12-item general health questionnaire and the clues of abnormal behavior of severe mental illness were used as screening tools,and the DSM-IV-TR axisⅠdisorder stereotyped clinical examination was used for diagnosis. The general social demographic characteristics,the prevalence rate and lifetime prevalence rate,the distribution characteristics of gender,age,area and education level were investigated in two stages,and further investigation was conducted on the medical history,medical service utilization,family social impact and medical security. Binary Logistic regression analysis was used to analyze the influencing factors of severe mental illness. Results Among the 72 999 people included in the result statistics,720 people suffered from severe mental disorders,the time point prevalence rate of severe mental diseases in the whole province was9. 35‰( 95% CI 5. 660‰-7. 450‰),of which the time point prevalence rate of schizophrenia was the highest[6. 50‰( 95% CI 5. 660‰-7. 450‰) ],and the lifetime prevalence rate was 10. 100‰( 95% CI 8. 780‰-11. 620‰) . The prevalence rates of severe mental illness in different education levels,different occupation types and different marital status groups were statistically significantly different( P < 0. 05) : the prevalence rates of illiteracy,unemployment and divorced population were 16. 950 ‰( 95 % CI 11. 530 ‰-24. 850 ‰),18. 220 ‰( 95 % CI 14. 050 ‰-23. 150 ‰) and 28. 610 ‰( 95 % CI18. 710‰-43. 520‰),respectively. Binary Logistic regression model ana

关 键 词：重性精神疾病 流行病学 患病率 湖南省 影响因素 

分 类 号：R749[医药卫生—神经病学与精神病学]