1990—2019年中国人群精神障碍疾病负担变化趋势及危险因素分析  

Trends of Burden on Mental Disorders and its Related Risk Factors in China,from 1990 to 2019

作　　者：尉力文 陈旭鹏[1] 严子康 杨华凤[1] Wei Liwen;Chen Xupeng;Yan Zikang(Nanjing Municipal Center for Disease Control and Prevention,Nanjing 210003)

机构地区：[1]南京市疾病预防控制中心,210003

出　　处：《中国卫生统计》2024年第4期511-516,共6页Chinese Journal of Health Statistics

基　　金：江苏省老年健康科研项目(LK2021006);南京市卫生科技发展项目(GBX21313)。

摘　　要：目的 分析1990—2019年中国人群精神障碍的流行状况、疾病负担变化趋势及危险因素。方法 从2019年全球疾病负担研究(global burden of disease, GBD)中获取中国人群精神障碍疾病负担指标,分析1990—2019年中国人群精神障碍患病率、伤残调整生命年(disability adjusted of life years, DALY)和归因危险因素DALY,采用Joinpoint 4.7估计精神障碍DALY率的年度变化百分比(annual percent change, APC)和平均年度变化百分比(average annual percent change, AAPC),分析精神障碍疾病负担的变化趋势。结果 2019年中国人群精神障碍患病率为11260.42/10万,抑郁症(3519.26/10万)和焦虑症(3363.60/10万)患病率最高。2019年女性DALY率(1564.22/10万)高于男性(1294.51/10万)。抑郁症(531.65/10万)、焦虑症(321.60/10万)和精神分裂症(43.15/10万)的DALY率最高,分别占2019年中国人群精神障碍总DALY率的37.26%、22.54%和17.59%。1990—2019年中国人群精神障碍DALY率由1321.15/10万增长至1426.78/10万,年龄标化DALY率呈下降趋势,平均每年下降0.19%(95%CI:-0.22%~-0.15%),但进食障碍年龄标化DALY率的增幅明显(AAPC=1.94%,95%CI:1.85%~2.02%)。2019年中国人群抑郁症归因于亲密伴侣暴力的DALY率最高(26.72/10万),1990—2019年男性抑郁症归因于童年性虐待的DALY率呈明显增长趋势(AAPC=0.68%,95%CI:0.26%~1.09%)。结论 应重视精神障碍疾病的防治,开展重点人群筛查并采取干预措施,针对危险因素开展病因预防,从而降低精神障碍导致的疾病负担。Objective To analyze the prevalence,burden and risk factors of mental disorders in Chinese population from 1990 to 2019.Methods Data on disease burden of mental disorders in China from 1990 to 2019 was obtained from the Global Burden of Disease(GBD)in 2019.The prevalence,disability adjusted of life years(DALY)and burden attributable to risk factors of mental disorders were analyzed.Joinpoint was used to estimate the annual percent change average(APC)and the annual percent change(AAPC)of DALY rate of mental disorders and analyze the trend of disease burden.Results In 2019,the prevalence of mental disorders was 11260.42/100000.Among mental disorders,depressive disorder(3519.26/100000)and anxiety disorder(3363.60/100000)had the highest prevalence.In 2019,the DALY rate of females(1564.22/100000)was higher than that of males(1294.51/100000).Depressive disorder(531.65/100000),anxiety disorder(321.60/100000)and schizophrenia(250.99/100000)had the highest DALY rates,accounting for 37.26%,22.54%and 17.59%of the total DALY rates of mental disorders respectively.From 1990 to 2019,the DALY rate of mental disorders in China increased from 1321.15/100000 to 1426.78/100000,the age-standardized DALY rate decreased with an average annual decrease of 0.19%(95%CI:-0.22%~-0.15%),and the age-standardized DALY rate of eating disorders increased the most(AAPC=1.94%,95%CI:1.85%~2.02%).The DALY rate of depressive disorder attributable to intimate partner violence was the highest in China in 2019(26.72/100000).The DALY rate of male depression attributed to childhood sexual abuse increased significantly from 1990 to 2019(AAPC=0.68%,95%CI:0.26%~1.09%).Conclusion Attention should be paid to the prevention and treatment of mental disorders,screening and intervention measures should be carried out among high risk populations,and etiological prevention should be carried out according to risk factors to reduce the burden of mental disorders.

关 键 词：精神障碍 疾病负担 抑郁 焦虑 进食障碍 

分 类 号：R195.1[医药卫生—卫生统计学]