中国成人心境障碍功能残疾的现况调查  

A cross-sectional study of functional disability prevalence of mood disorders and risk factors in Chinese adults

作　　者：王咏诗 黄悦勤 刘肇瑞[2] 马超[2] 张婷婷 彭睿[2] 肖水源 李凌江[4] 徐一峰[5] 李涛[6,15] 许秀峰[7,16] 于雅琴 闫永平[9] 王志忠 徐向东[11] 王丽敏[12] 李强 徐广明[14] WANG Yongshi;HUANG Yueqin;LIU Zhaorni;MA Chao;ZHANG Tingting;PENG Rui;XIAO Shuiyuan;LI Lingiang;XU Yifeng;LI Tao;XU Xiufeng;YU Yaqin;YAN Yongping;WANG Zhizhong;XU Xiangdong;WANG Limin;LI Qiang;XU Guangmng(Institute of Medical Technology,Peking University Health Science Center,Beijing 100083,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Reseach Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100083,China;Department of Social Medicine and Health Management,School of Pblic Health,Central South University,Changsha 410078,China;Mental Health Institute,the Second Xiangya Hospital,Central-south University,Changsha 410011,China;Shanghai Mental Healti Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China;Mental Heahh Centre of West China Hospital,Sichuan University,Chengdu 610041,China;Department of Psychiatry,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Department of Epidemiology and Bistatistics,School of Public Health,Jilin University,Changchun 130021,China;Department of Epidemiology,the Fourth Military Medical University,Xi'an 710032,China;Department of Epidemiology and Satistics,School of Publie Halth and Mana gement,Ningxia Medical University,Yinchuan 750004,China;The Fourth People's Hospital in Urumqi,Urumqi 830002,China;National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Bejing 100050,China;Institute of Social Science Survey,Peking Univerpity,Beijing 100871,China;Tianjin Anding Hospital,Mental Health Center of Tianjin Medical University,Tianjin 300222,China)

机构地区：[1]北京大学医学部医学技术研究院,北京100083 [2]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083 [3]中南大学公共卫生学院,长沙410078 [4]中南大学湘雅二医院精神卫生研究所,长沙410011 [5]上海市精神卫生中心,上海200030 [6]四川大学华西医院心理卫生中心,成都610041 [7]昆明医科大学第一附属医院,昆明650032 [8]吉林大学公共卫生学院,长春130021 [9]中国人民解放军空军军医大学,西安710032 [10]宁夏医科大学公共卫生与管理学院流行病与卫生统计学系,银川750004 [11]乌鲁木齐市第四人民医院,乌鲁木齐830002 [12]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [13]北京大学中国社会科学调查中心,北京100871 [14]天津市安定医院,天津300222 [15]浙江大学医学院附属精神卫生中心/杭州市第七人民医院 [16]珠海科技健康学院 [17]广东医科大学

出　　处：《中国心理卫生杂志》2023年第9期751-757,共7页Chinese Mental Health Journal

基　　金：公益性行业科研专项项目(201202022);国家科技支撑计划(2021BAI01B01);国家重点研发计划(2017YFC0907800,2017YFC0997801)。

摘　　要：目的:描述中国社区成人心境障碍功能残疾现况并探讨残疾发生的危险因素,为精神残疾康复政策的制定提供科学依据。方法:本研究为中国精神卫生调查数据的深入分析,计算包含身心共病和单一心境障碍的12月加权功能残疾率和致残率、对正常工作和生活的损失天数的影响;运用方差分析比较各组世界卫生组织残疾评定量表-2.0得分的差异,运用复杂抽样数据多重线性回归分析心境障碍共病其他精神障碍和躯体疾病及人口学因素对功能残疾程度的影响。结果:心境障碍12月患病人数为1136例,其中功能残疾人数为537例,包含身心共病的心境障碍功能残疾率为1.7%、致残率为42.0%,第四级残疾构成比最高(77.1%)。单一心境障碍功能残疾率为0.2%、致残率为16.0%。各类心境障碍所致部分影响正常生活和工作的中位天数在0~4.75 d之间。多重线性回归显示,心境障碍共病其他精神障碍和躯体疾病及除居住地以外的人口学因素均与WHODAS 2.0得分呈正关联。结论:心境障碍共病躯体疾病增加功能残疾发生的易患性和严重程度。受教育程度和收入水平低、高龄、非在婚、男性群体是心境障碍功能残疾的高危人群,需要重点关注。Objective:To describe functional disability prevalence of mood disorders in Chinese adults and ex-plore related risk factors of disability occurrence in order to provide scientific evidence of policy making on disabili-ty rehabilitation.Methods:The current study was in-depth data analysis of China Mental Health Survey.Weighted 12-month functional disability prevalence of mood disorder with comorbidities and single mood disorder in popula-tion and those in patients,and days of partial disability were calculated.Difference of World Health Organization Disability Assessment Schedule 2.0 scores among groups was tested by ANOVA.The effects of mental disorders comorbid physical diseases and demographic factors on the occurrence and severity of disability were analyzed by muliple linear regression for complex sampling data.Results:Totally 1136 patients with mood disorders in the past 12 months were diagnosed,and 537 of them suffered from functional disability.The functional dis ability prevalence of mood disorder with comorbidities in population was 1.7%,and disability prevalence of mood disorders in pa-tients was 42.0%,in which constituent rate of grade-four disability was highest as 77.1%.The functional disability prevalence of single mood disorder in population was 0.2%,and disability prevalepce of single mood disorder in patients was 16.0%.The median days of partial disability days were from 0 to 4.75.Multiple linear regression showed a positive association between mental disorders comorbid physical diseases,demographic factors and WHO-DAS 2.0 scores except living area.Conclusions:Comorbidity of mood disorders and physical diseases increases the likelihood and severity of functional disability.Those with older age,lower economic and education level,non mar-ried and males are at high risk of mood disorder disability and need to be paid attention to.

关 键 词：心境障碍 精神残疾 残疾率 致残率 危险因素 现况调查 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R181.32[医药卫生—临床医学]