中国社区成人焦虑障碍功能残疾现况调查  

A cross-sectional study of functional disability rate of anxiety disorder and risk factors in Chinese community adults

作　　者：李扬 黄悦勤 刘肇瑞[2] 张婷婷[2] 马超[2] 李凌江 徐一峰[4] 李涛[5,15] 许秀峰[6] 于雅琴 闫永平[8] 王志忠[9,17] 徐向东 王丽敏[11] 李强 徐广明[13] 肖水源[14] LI Yang;HUANG Yueqin;LIU Zhaorui;ZHANG Tingting;MA Chao;LI Lingiang;XU Yifeng;LI Tao;XU Xiufeng;YU Yaqin;YAN Yongping;WANG Zhizhong;XU Xiangdong;WANG Limin;LI Qiang;XU Guangming;XIAO Shuiyuan(Institute of Medical Technology,Peking University Health Science Center,Beijing 100191,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Bejjing 100083,China;Mental Health Institute,the Second Xiangya Hospital,Central-south University,Changsha 410011,China;Shanghai Mental Health Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China;Mental Health Centre of West China Hospital,Sichuan University,Chengdu 610041,China;Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;School of Public Health,Jilin University,Changchun 130021,China;Department of Epidemiology,School of Public Health,the Fourth Military Medical University,Xi'an 710032,China;Department of Epidemiology and Statistics,School of Public Health and Management,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,Beiing 100050,China;Institute of Social Science Survey,Peking University,Beijing 100871,China;Tianjin Anding Hospital,Mental Health Center of Tianjin Medical University,Tianjin 300222,China;School of Public Health,Central South University,Changsha 410078,China)

机构地区：[1]北京大学医学部医学技术研究院,北京100191 [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]中南大学湘雅二医院精神卫生研究所,长沙410011 [4]上海市精神卫生中心,上海交通大学医学院,上海200030 [5]四川大学华西医院心理卫生中心,成都610041 [6]昆明医科大学第一附属医院精神科,昆明650032 [7]吉林大学公共卫生学院,长春130021 [8]第四军医大学,预防医学系流行病学教研室,西安710032 [9]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 [10]乌鲁木齐市第四人民医院,乌鲁木齐830002 [11]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 [12]北京大学中国社会科学调查中心,北京100871 [13]天津市安定医院,天津医科大学精神卫生中心,天津300222 [14]中南大学公共卫生学院,长沙410078 [15]浙江大学医学院精神卫生中心/杭州市第七人民医院 [16]珠海科技学院 [17]广东医科大学

出　　处：《中国心理卫生杂志》2024年第11期929-935,共7页Chinese Mental Health Journal

基　　金：国家重点研发计划(2017YFC0907800、2017YFC0907801);“十二五”国家科技支撑计划(2012BAI01B01);卫生部公益性行业科研专项(201202022)。

摘　　要：目的:描述中国社区成人焦虑障碍功能残疾现况,探讨功能残疾的危险因素。方法:对中国精神卫生调查数据进行深入分析,焦虑障碍诊断工具是以精神障碍诊断与统计手册第4版为诊断标准的复合性国际诊断交谈表-3.0,世界卫生组织残疾评定量表第二版为焦虑障碍功能残疾评定标准。计算焦虑障碍功能残疾率、致残率,影响正常工作和生活的天数;以多重线性回归和logistic回归分析共病及人口学因素对残疾严重程度和功能残疾发生的影响。结果:焦虑障碍加权功能残疾率和致残率分别为1.7%和42.2%,其中四级残疾构成比最高(84.1%),单纯焦虑障碍加权功能残疾率和致残率分别为0.3%和17.8%。各类焦虑障碍过去30 d部分影响正常工作和生活天数的中位数为0~14.42 d。多重线性回归分析显示,焦虑障碍共病其他精神障碍和躯体疾病(β=0.24)、其他精神障碍共病躯体疾病(β=0.21)、躯体疾病(β=0.18)、焦虑障碍共病躯体疾病(β=0.15)、焦虑障碍共病其他精神障碍(β=0.08)、其他精神障碍(β=0.07)、单纯焦虑障碍(β=0.06)、低受教育程度(β=0.12)、低收入水平(β=0.08)、高龄(β=0.06)、非在婚状态(β=0.06)、男性(β=0.02)与残疾严重程度正关联。Logistic回归分析显示,功能残疾发生的危险因素为:焦虑障碍共病其他精神障碍和躯体疾病(OR=64.07)、焦虑障碍共病其他精神障碍(OR=36.75)、其他精神障碍共病躯体疾病(OR=20.60)、焦虑障碍共病躯体疾病(OR=18.88)、焦虑障碍(OR=9.20)、其他精神障碍(OR=6.65)、躯体疾病(OR=4.00)、65岁及以上(OR=4.40)、50~64岁(OR=2.33)、低收入水平(OR=2.10)、文盲及小学以下受教育程度(OR=1.89)、中收入水平(OR=1.70)、小学受教育程度(OR=1.59)、非在婚状态(OR=1.47)和男性(OR=1.16)。结论:焦虑障碍共病其他精神障碍和躯体疾病增加功能残疾的发生和严重程度,共病其他精神障碍和躯体疾病、男性、�Objective:To describe functional disability rate of anxiety disorders in Chinese community adults and explore related risk factors of functional disability.Methods:To conduct in-depth data analysis on China Mental Health Survey(CMHS).The diagnostic tool for anxiety disorders was the Composite International Diagnostic Interview-3.0,according to the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition(DSM-IV).The World Health Organization Disability Assessment Schedule, 2nd edition, was the functional disability assessment standard for anxiety disorders.Weighted 12-month functional disability rate of DSM-Ⅳ anxiety disorder with comorbidities and only anxiety disorder in population and those in patients, as well as days of partial disability were calculated.The effects of anxiety disorders comorbid other mental disorders and physical diseases and demographic factors on the severity and occurrence of functional disability were analyzed by multiple linear regression and logistic regression.Results:The functional disability rate of anxiety disorder with comorbidities in population was 1.7%,and 42.2% in patients, in which constituent rate of grade-four disability was the highest as 84.1%.The functional disability rate of only anxiety disorder in population was 0.3%,and 17.8% in patients.The medians of days of partial disability days in the past 30 days were from 0 to 14.42.Multiple linear regression showed a positive association between comorbid anxiety disorder with other mental disorders and physical diseases(β=0.24),comorbid other mental disorders and physical diseases(β=0.21),physical diseases(β=0.18),comorbid anxiety disorder and physical diseases(β=0.15),comorbid anxiety disorder with other mental disorders(β=0.08),other mental disorders(β=0.07),only anxiety disorder(β=0.06),lower education level(β=0.12),lower economic status(β=0.08),older age(β=0.06),non-marital status(β=0.06),male(β=0.02) and the severity of functional disability.Logistic regression showed that comorbid anxiety wi

关 键 词：焦虑障碍 精神残疾 残疾率 致残率 危险因素 现况调查 

分 类 号：R749.72[医药卫生—神经病学与精神病学] R181.32[医药卫生—临床医学]