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1.
目的:调查西藏自治区林周县重性精神障碍流行病学状况。方法:2019年5月对林周县全人群重性精神障碍(精神分裂症、分裂情感性障碍、偏执性精神病、双相障碍、癫痫所致精神障碍、精神发育迟滞伴发精神障碍)开展筛查;对筛查出的疑似重性精神障碍患者以《国际疾病分类》第10版(ICD-10)为诊断标准进行入户面对面访谈以确诊;并调查确诊者人口学及治疗情况。结果:全县初筛了62 171人;114例确诊为重性精神障碍;男性患者比率(49.1%,56例)与女性患者比率(50.9%,58例)差异无统计学意义(P0.05);诊断为精神发育迟滞伴精神障碍68例,癫痫所致精神障碍11例,精神分裂症31例,情感障碍4例。重性精神障碍终生患病率1.83‰;终生患病率由高到低依次为精神发育迟滞伴精神障碍(1.09‰)、精神分裂症(0.50‰),癫痫所致精神障碍(0.18‰),双相障碍(0.06‰);延误治疗比例较高(77.2%),其中精神分裂症患者非延误治疗的比率相对较高,中断治疗的比率相对较低;双相障碍患者延误治疗时间相对较短;癫痫所致精神障碍延误治疗时间短,无中断治疗者;精神发育迟滞伴精神障碍患者得到精神卫生服务情况最差。结论:林周县重性精神障碍患病率较低,精神卫生服务情况也较差。  相似文献   

2.
目的分析六类重性精神疾病患者及有两害行为的其他精神疾病患者的出院信息特征,为社区防治提供参考。方法选择2015年3月-8月在首都医科大学附属北京安定医院出院的所有符合《国际疾病分类(第10版)》(ICD-10)精神障碍诊断标准的六类重性精神疾病患者及有两害行为的其他精神障碍患者,对患者出院时医生填写的严重精神障碍患者出院信息单进行分析。结果 1该院出院的重性精神疾病患者以双相情感障碍和精神分裂症为主,分别占47.55%、43.00%。2存在两害行为的重性精神疾病患者占52.73%,两害行为发生率男性高于女性(P0.01)。3精神分裂症和双相情感障碍患者平均住院时间差异有统计学意义(Z=9.907,P0.01)。精神分裂症和双相情感障碍患者起病年龄在14~25岁的分别占57.19%、52.77%,住院次数≥2次的分别占67.55%、64.25%,病程≥5年的分别占64.38%、60.33%。结论 1双相情感障碍和精神分裂症是重性精神疾病防治的重点。2双相情感障碍和精神分裂症患者起病年龄早,住院次数多,病程长,两害行为发生比例高。  相似文献   

3.
刘敏东  陈春  梁映 《四川精神卫生》2015,28(5):478-附1
<正>严重精神障碍是指疾病症状严重,导致患者社会适应等功能严重损害、对自身健康状况或者客观现实不能完整认识,或不能处理自身事务的精神障碍[1],由于患者病情较严重,对患者自己、他人乃至社会产生危害行为的可能性要大于其他精神障碍患者。其中精神分裂症、分裂情感性障碍、偏执性精神病、双相障碍、癫痫所致精神障碍、精神发育迟滞伴发精神障碍六类精神障碍统称为重性精神疾病[2],根据《重性精神疾病管理治疗工作规范(2012年  相似文献   

4.
目的探讨性犯罪的特点,为预防、减少性犯罪的发生提供参考。方法对四川正泰精神医学司法鉴定所2009年1月-2012年8月进行性犯罪司法精神医学鉴定40例案例资料进行一般人口学、案件资料、医学诊断情况及刑事责任能力评定等相关数据进行分析。结果本组作案者40例均为男性,作案对象55人次均为女性;作案者以精神发育迟滞居多(45%),其余依次为无精神疾病(27.5%)、精神分裂症(25%)、酒精所致精神障碍(2.5%);年龄14~73岁,平均年龄(34.15±13.04)岁,其中以18~45岁占绝大多数(80%);文化程度低,小学和文盲占绝大多数(70%);职业以农民为主(80%);婚姻以未婚居多(72.5%),其余依次为已婚(20%)、离婚(7.5%);少数案例有精神病家族史(12.5%)。选择的作案对象以青少年和儿童为主(85.5%),其中74.5%是留守儿童;作案地点以郊外居多(57.5%),其次为作案人或作案对象家里;作案时间绝大多数选择在白天(92.5%);大多数是第一次作案(75%),所有案例均为单独作案,没有任何人指使。判定为无刑事责任能力12例(30%),部分刑事责任能力2例(5%),完全刑事责任能力26例(65%)。结论性犯罪是男性精神疾病患者一大危险,要防止和减少精神疾病患者性犯罪,必须加强对精神发育迟滞、精神分裂症等精神疾病患者的治疗和管理工作;加强对留守儿童、留守妇女保护工作。  相似文献   

5.
目的了解上海市2002年全年在市级精神卫生中心门诊初诊的重性精神疾病患者诊治状况,为及时有效实施监护和干预、减少肇事肇祸的发生提供信息.方法收集全年门诊初诊重性精神疾病患者的就诊资料,按人口学特征和疾病特征进行统计分析.结果全年(2002年1~12月)门诊初诊患者9200例,其中重性精神疾病患者2090例(22.72%),男性925(44.26%)女性1165(55.74%)男女之比为11.26;平均年龄(39.37±16.14)岁;重性精神疾病初诊以精神分裂症为多1101人(52.68%),其次情感性障碍有718人(34.36%).各种病的年龄特征精神分裂症以20~30岁多见(51.68%),情感障碍以41~60岁较多(45.69%),酒依赖41~50岁;疾病的职业分布在业与重性精神疾病初诊关系中发现精神分裂症和情感性精神障碍以工人为多,分别132人(39.88%)和86人(36.29%),而且占所有重性精神疾病初诊病人的比例也相对地高274人(42.15%),技术员和职员其次,精神分裂症职员71人(21.45%),技术员68人(20.54%),情感性精神障碍技术员50人(21.10%),职员46人(19.41%),酒依赖也以工人为多占整个酒依赖的68.97%.人(42.15%),不在业的病种分布精神分裂症以学生和无职业者为多,分别为218人(28.31%)和298人(38.70%);而情感性精神障碍和器质性精神障以离退休多见,分别249人(61.10%)和39人(66.10%);地域分布中各区、县精神分裂症和情感性精神障碍初诊情况,以浦东新区(15.01%)和徐汇区(13.80%)为多,普陀(9.18%)和杨浦(7.75%)其次,而郊区较少.可能与经济状况、就医习惯、宣传力度、地域、人口、交通等因素有关.精神分裂症和情感性障碍的就诊月份分布似乎无明显差异.  相似文献   

6.
文红  王丹  王维 《四川精神卫生》2014,27(4):337-340
目的分析四川省参与社区管理的重性精神病患者死亡变化趋势和死亡原因,探讨降低其死亡的干预措施。方法对2011年-2013年四川省参与社区管理的重性精神病患者个人基本信息及乡镇(社区)防保医生上门访视的随访信息、失访(死亡)患者登记表进行统计分析。结果截止2013年12月底四川省参与社区管理的重性精神病患者达17.1万。2011-2013年间其死亡人数为3248人(1.89%),其中,精神分裂症2757例(84.88%),精神发育迟滞169例(5.20%),癫痫所致精神障碍164例(5.05%),双相情感障碍92例(2.83%),分裂情感性障碍46例(1.42%),偏执性精神病20例(0.62%)。各年度死亡率比较,城市与农村比较,差异均有统计学意义(P0.01)。其前5位死因依次为:躯体疾病、其他(不明原因死亡)、意外、精神疾病相关并发症及自杀。死亡前得到有效治疗的比例为0.62%~1.15%。结论四川省参与社区管理的重性精神病患者死亡率高于普通人群;加强救治和管理是降低其死亡率的关键;提高各级精神卫生专科机构及基层医疗机构的规范化诊治水平,是降低重性精神病患者死亡率的重点。  相似文献   

7.
江苏无锡地区精神疾病流行学调查分析   总被引:2,自引:1,他引:1  
使用定式调查程序,对无锡地区1000户6岁以上人群3205人进行调查,结果各类精神疾病总患病率为12.43‰,其中精神分裂症患病率最高,为5.62‰,其次是精神发育迟滞为2.96‰,情感性精神障碍为1.48‰,心因性精神障碍为1.18‰,癫痫性精神障碍为0.89‰和老年性痴呆为0.29‰。  相似文献   

8.
于1990年11月至1991年1月对徐州市的两个区中18个街道的54个居委会,随机抽查3240户计9636人的精神疾病和社会心理因素情况,发现有精神分裂症39人,患病率为4.0‰,精神发育迟滞17人,患病率为1.8‰,癫痫及其精神障碍5人,患病率为0.5‰。其它精神疾病12人,患病率为1.2‰。 73例精神疾病患者中男47例,女26例。精神分裂症的病程7个月~49年,平均18.7年;39例中有11例  相似文献   

9.
目的 探讨精神疾病患者涉案特征.方法 对宜春市第三人民医院1999~2008年鉴定的741例精神疾病案例进行统计分析.结果 在全部案例中,男女涉案比例为1.35:1.以初中文化以下青壮年居多,职业以无业和农民为主,鉴定案件呈逐年上升趋势.精神分裂症作案占刑事案例41.8%,以凶杀伤害等暴力犯罪为主:精神发育迟滞患者占受害案例27.7%,以被强奸案为主,而近三年交通事故造成的脑外伤所致精神障碍呈迅速上升态势.结论 不同精神疾病涉案特征有所不同,交通事故造成的脑外伤案例明显增加.  相似文献   

10.
目的分析上海市长宁区社会工作者介入重性精神疾病社区服务的状况。方法从组织架构、日常管理、实施效果等方面进行初步研究。结果长宁区精神卫生社工站采用民办非企业模式运作,为社区患者及家属等提供服务,包括建档立卡、个案服务、小组服务、便利服务、社区公益服务等。社工/服务对象比例为1:50,病种以精神分裂症、双相障碍等重性精神疾病为主,在管患者规范管理率达95.01%,稳定率达96.5%,肇事肇祸率为0。结论精神卫生社工服务模式整合多元资源,承接政府购买服务项目,一定程度上缓解社区供需矛盾,为在大中型城市推广实施提供了范例。  相似文献   

11.
保定市焦虑障碍流行病学调查   总被引:2,自引:0,他引:2  
目的:了解保定市焦虑障碍的患病率和分布特点。方法:于2004年10月至2005年5月采用多阶段分层整群抽样方法随机抽取≥18岁的人群,共10073名,用扩展的一般健康问卷(GHQ-12)将调查对象分为高、中、低危险组,采用美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查患者版(SCID)对调查对象进行焦虑障碍的诊断。结果:共9021人完成调查,焦虑障碍的终生患病率为45.12‰,时点患病率为41.79‰,5种常见的焦虑障碍是未特定的焦虑障碍(分别是25.72‰及25.39‰)、创伤后应激障碍(5.65‰及3.66‰)、广泛性焦虑症(仅现患6.43‰)、特殊恐怖症(5.10‰及4.43‰)和惊恐障碍(3.44‰及2.66‰)。时点患病率:女性(54.21‰)明显高于男性(29.73‰)(P〈0.01);50~59岁患病率最高(58.39‰),20~29岁最低(23.07‰)。Logistic回归分析显示,焦虑障碍的易患危险因素为女性、年龄40-69岁、低文化、低收入。焦虑障碍的精神科就诊率为1.86‰。结论:焦虑障碍是保定市常见的一类精神障碍,患病率高,而其精神卫生服务利用率低。  相似文献   

12.
To estimate the prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) mental disorders in community populations in Japan, face-to-face household surveys were conducted in four community populations in Japan. A total of 1663 community adults responded (overall response rate, 56%). The DSM-IV disorders, severity, and treatment were assessed with the World Mental Health version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered psychiatric diagnostic interview. The prevalence of any WMH-CIDI/DSM-IV disorder in the prior year was 8.8%, of which 17% of cases were severe and 47% were moderate. Among specific disorders, major depression (2.9%), specific phobia (2.7%), and alcohol abuse/dependence (2.0%) were the most prevalent. Although disorder severity was correlated with probability of treatment, only 19% of the serious or moderate cases received medical treatment in the 12 months before the interview. Older and not currently married individuals had a greater risk of having more severe DSM-IV disorders if they had experienced any within the previous 12 months. Those who had completed high school or some college were more likely to seek medical treatment than those who had completed college. The study confirmed that the prevalence of DSM-IV mental disorders was equal to that observed in Asian countries but lower than that in Western countries. The percentage of those receiving medical treatment was low even for those who suffered severe or moderate disorders. Possible strategies are discussed.  相似文献   

13.
OBJECTIVE: This study examined relationships between homelessness, mental disorder, violence, and the use of psychiatric emergency services. To the authors' knowledge, this study is the first to examine these issues for all episodes of care in a psychiatric emergency service that serves an entire mental health system in a major city. METHODS: Archival databases were examined to gather data on all individuals (N=2,294) who were served between January 1, 1997, and June 30, 1997, in the county hospital's psychiatric emergency service in San Francisco, California. RESULTS: Homeless individuals accounted for approximately 30 percent of the episodes of service in the psychiatric emergency service and were more likely than other emergency service patients to have multiple episodes of service and to be hospitalized after the emergency department visit. Homelessness was associated with increased rates of co-occurring substance-related disorders and severe mental disorders. Eight percent of persons who were homeless had exhibited violent behavior in the two weeks before visiting the emergency service. CONCLUSIONS: Homeless individuals with mental disorders accounted for a large proportion of persons who received psychiatric emergency services in the community mental health system in the urban setting of this study. The co-occurrence of homelessness, mental disorder, substance abuse, and violence represents a complicated issue that will likely require coordination of multiple service delivery systems for successful intervention. These findings warrant consideration in public policy initiatives. Simply diverting individuals with these problems from the criminal justice system to the community mental health system may have limited impact unless a broader array of services can be brought to bear.  相似文献   

14.
目的分析深圳市社区严重精神障碍不服药患者暴力行为发生的相关因素。方法利用深圳市精神卫生防治工作信息管理系统收集严重精神障碍患者个案资料和随访资料,描述分析不服药患者暴力行为的发生现状,应用Logistic回归模型分析其影响因素。结果3163例社区严重精神障碍不服药患者中9.1%(288/3163)的患者发生暴力行为。多元Logisitic回归分析显示,急性起病(OR=1.589,95%CI 1.181~2.139)为暴力行为发生的危险因素;有共同居住者(OR=0.596,95%CI 0.410~0.867)、精神发育迟滞伴发精神障碍(OR=0.432,95%CI 0.199~0.938)、申请监护补助(OR=0.440,95%CI 0.319~0.606)、签约家庭医师服务(OR=0.642,95%CI 0.492~0.838)和社区面访(OR1-2次=0.633,95%CI 0.466~0.861;OR3-4次=0.546,95%CI 0.368~0.811)为暴力行为发生的保护因素。结论急性起病的严重精神障碍不服药患者暴力行为发生率较高。提升社区精神卫生综合服务水平,制定有针对性的干预措施,有助于降低社区严重精神障碍不服药患者暴力行为的发生。  相似文献   

15.
威海市精神疾病流行病学调查   总被引:1,自引:0,他引:1  
目的:了解威海市≥15岁人群各类精神疾病的患病率和分布特点。方法:2006年9月至2007年2月随机抽取≥15岁人群共50174人,使用心理卫生筛选表、神经症筛选表、精神现状检查(PSE)140题等工具进行调查,以中国精神疾病分类方案与诊断标准第3版为诊断依据。结果:各类精神障碍的时点患病率为70.34‰,终生患病率为89.51‰。排在前3位的为抑郁症(37.49‰)、神经症(30.06‰)和酒依赖(11.38‰)。农村患病率(93.22‰)高于城市(84.30‰),女性(95.27‰)高于男性(83.82‰)。3种精神疾病均存在较高的未识别率,且农村高于城市。结论:山东威海市精神疾病的患病率以女性和农村较高;抑郁症是威海市患病率最高的精神疾病。  相似文献   

16.
目的:了解武汉市武昌区重性精神疾病患者的现状与相关因素之间的关系,为社区有效管理提供依据。方法资料来源于国家重性精神疾病网络管理系统,对武昌区3358例重性精神疾病患者的相关数据进行描述性分析,对患者病程及疾病类型的影响因素进行 Logistic 回归分析。结果武昌区网络管理的重性精神疾病患者中单身者占59.38%,初中及以下文化程度者占60.18%,家庭经济状况贫困者占43.33%,无业或下岗者占60.76%。Logistic回归分析发现,经济状况(OR =0.896)、文化程度(OR =1.430)会影响病程;文化程度(OR =0.549)、经济状况(OR =1.212)、婚姻(OR =1.183)、职业(OR =1.215)会影响精神疾病类型。结论应将精神分裂症、精神发育迟滞(伴发精神障碍)作为管理重点,尤其是对未服药及依从性差的患者。  相似文献   

17.
BACKGROUND: We report on mental disorders and violence for a birth cohort of young adults, regardless of their contact with the health or justice systems. METHODS: We studied 961 young adults who constituted 94% of a total-city birth cohort in New Zealand, April 1, 1972, through March 31, 1973. Past-year prevalence of mental disorders was measured using standardized DSM-III-R interviews. Past-year violence was measured using self-reports of criminal offending and a search of official conviction records. We also tested whether substance use before the violent offense, adolescent excessive perceptions of threat, and a juvenile history of conduct disorder accounted for the link between mental disorders and violence. RESULTS: Individuals meeting diagnostic criteria for alcohol dependence, marijuana dependence, and schizophrenia-spectrum disorder were 1.9 (95% confidence interval [CI], 1.0-3.5), 3.8 (95% CI, 2.2-6.8), and 2.5 (95% CI, 1.1-5.7) times, respectively, more likely than control subjects to be violent. Persons with at least 1 of these 3 disorders constituted one fifth of the sample, but they accounted for half of the sample's violent crimes (10% of violence risk was uniquely attributable to schizophrenia-spectrum disorder). Among alcohol-dependent individuals, violence was best explained by substance use before the offense; among marijuana-dependent individuals, by a juvenile history of conduct disorder; and among individuals with schizophrenia-spectrum disorder, by excessive perceptions of threat and a history of conduct disorder. CONCLUSIONS: In the age group committing most violent incidents, individuals with mental disorders account for a considerable amount of violence in the community. Different mental disorders are linked to violence via different core explanations, suggesting multiple-targeted prevention strategies.  相似文献   

18.
ObjectiveThe aims of this study were to understand the mental health of single fathers relative to married fathers as the population of single fathers continues to increase and to use the resultant data for the establishment of public health policies.MethodsWe evaluated the mental health of 58 single fathers and 256 married fathers living in an urban community in South Korea. Self-reported questionnaires including the Global Assessment of Recent Stress, Center for Epidemiologic Studies–Depression, Scale for Suicidal Ideation, the Korean version of the Alcohol Use Disorder Identification Test, and the World Health Organization Quality of Life Assessment Instrument were used for evaluation. The mental health scale scores and the prevalence of mental health problems were compared between the single and the married fathers. We also assessed the factors associated with poor QOL, depressive symptoms, and severe stress among single fathers.ResultsThe single fathers had poorer quality of life (OR 7.30, 95% CI 2.82–18.74), more depressive symptoms (OR 3.85, 95% CI 1.29–11.45), and more stress (OR 3.36, 95% CI 1.25–8.98) than did the married fathers even after controlling for socio-demographic factors. Among the single fathers, poor socioeconomic conditions, such as no house ownership, manual occupations, having two or more children, and having a youngest child in elementary school or middle school, were significantly associated with poorer mental health.ConclusionsThis study demonstrated that single fathers have poorer mental health than do married fathers. Single parenthood was significantly associated with their mental health. Therefore, we should attempt to provide practical support to reduce the social burden and offer earlier psychological interventions to reduce distress in single fathers.  相似文献   

19.
Days out of role because of health problems are a major source of lost human capital. We examined the relative importance of commonly occurring physical and mental disorders in accounting for days out of role in 24 countries that participated in the World Health Organization (WHO) World Mental Health (WMH) surveys. Face-to-face interviews were carried out with 62?971 respondents (72.0% pooled response rate). Presence of ten chronic physical disorders and nine mental disorders was assessed for each respondent along with information about the number of days in the past month each respondent reported being totally unable to work or carry out their other normal daily activities because of problems with either physical or mental health. Multiple regression analysis was used to estimate associations of specific conditions and comorbidities with days out of role, controlling by basic socio-demographics (age, gender, employment status and country). Overall, 12.8% of respondents had some day totally out of role, with a median of 51.1 a year. The strongest individual-level effects (days out of role per year) were associated with neurological disorders (17.4), bipolar disorder (17.3) and post-traumatic stress disorder (15.2). The strongest population-level effect was associated with pain conditions, which accounted for 21.5% of all days out of role (population attributable risk proportion). The 19 conditions accounted for 62.2% of all days out of role. Common health conditions, including mental disorders, make up a large proportion of the number of days out of role across a wide range of countries and should be addressed to substantially increase overall productivity.  相似文献   

20.

Purpose

Community surveys of mental disorders and service use are important for public health policy and planning. There is a dearth of information for Latin America. This is the first representative community survey in the Argentinean population. The purpose is to estimate the 12-month prevalence and severity of mental disorders, socio-demographic correlates and service use in a general population survey of adults from urban areas of Argentina.

Methods

The World Mental Health Composite International Diagnostic Interview was administered to 3927 individuals aged 18 years and older participating in a multistage clustered area probability household survey. The response rate was 77%.

Results

The 12-month prevalence of any disorder was 14.8%, and a quarter of those disorders were classified as severe. Younger participants and those with lower education had greater odds of any disorder and most classes of disorder. 11.6% of the total population received treatment in the prior 12 months and only 30.2% of those with a severe disorder. Women and those never married were more likely to receive or seek treatment, whereas those with low and low-average education were less likely.

Conclusion

Most individuals with a mental disorder in the past year, even those with a severe disorder, have not received treatment. Because low education is a barrier to treatment, initiatives aimed at mental health education might help timely detection and treatment of these disorders in Argentina.
  相似文献   

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