山东省18岁及以上人群精神障碍流行病学调查

目的调查山东省18岁及以上人群精神障碍的患病率及其分布特点。方法于2015年在山东省49个县(市、区)开展精神障碍流行病学调查,采用多阶段分层整群抽样方法,抽取山东省≥18岁人群28 000人,利用修订的一般健康问卷进行筛查,将调查对象分为精神障碍高危和低危人群,采用DSM-Ⅳ、SCID-Ⅰ/P或MMSE对高危人群进行疾病诊断,随机抽取10%的低危人群进行有无精神障碍的诊断。计算患病率并根据研究设计和抽样人口的特征调整患病率和95%的可信区间。采用χ²检验和Fisher确切概率法对组间患病率差异进行比较。结果完成调查27 489人,调整后精神障碍患病率为17.46% (95%CI 17.02%~17.89%)。各类精神障碍中患病率排在前五位的分别是物质使用障碍(5.29%)、心境障碍(4.47%)、焦虑障碍(4.46%)、智力及缘于躯体和物质的障碍(1.91%)和精神病性障碍(1.12%),其中最常见的是酒精使用障碍(5.27%)和重性抑郁障碍(2.14%)。男性精神障碍患病率高于女性(23.37%与13.89%;χ²=408.91,P<0.01)。农村居民精神障碍的患病率与城市居民之间的差异无统计学意义(17.69%与17.20%;χ²=1.05,P=0.305)。26.12%(1 047/4 008)的精神障碍患者有中等到严重的功能损害,仅有10.98%(428/3 898)曾经寻求过专业帮助。结论山东省18岁及以上人群精神障碍患病率与国内同类研究结果基本一致,男性高于女性,城乡无差异;常见的精神障碍为酒精使用障碍、重性抑郁障碍、未特定焦虑障碍、未特定抑郁障碍。

An epidemiological survey of mental disorders among people aged 18 and above in Shandong Province

Objective This study aims to investigate the prevalence and distribution characteristics of mental disorders among people aged 18 and above in Shandong Province.Methods In 2015,an epidemiological survey was carried out to investigate the patterns of mental disorders in 49 counties of Shandong Province.A total of 28000 individuals aged 18 years or older were selected using the multistage stratified cluster sampling method.All these participants were classified as at a high or low risk of mental disorders according to the assessment results of the revised version of the General Health Questionnaire(GHQ).The diagnosis of mental disorders was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual,Forth edition(DSM-Ⅳ)axis I or MMSE.All participants at high risk of mental disorders were evaluated using DSM-Ⅳor MMSE to confirm the psychiatric diagnoses,while 10%of participants at low risk of mental disorders were randomly selected to be evaluated.The prevalence and its 95%confidence interval of mental disorders were adjusted according to study design and sociodemographic characteristics of the sample.The between-group differences of prevalence were compared using chi-square tests or Fisher′s exact tests as appropriately.Results A total of 27489 individuals completed survey.The adjusted prevalence of any mental disorder was 17.46%(95%CI 17.02%-17.89%).The five most prevalent mental disorder spectrums were substance use disorders(5.29%),mood disorders(4.47%),anxiety disorders(4.46%),intellectual and mental disorders due to physical or substance(1.91%),and psychotic disorders(1.12%).The most common mental disorders were alcohol use disorder(5.27%)and major depressive disorder(2.14%).The prevalence of mental disorders in men was higher than that in women(23.37%vs.13.89%;χ2=408.91,P<0.01).There was no significant difference in the prevalence of mental disorders between rural residents and urban residents(17.69%vs.17.20%;χ2=1.05,P=0.305).Of participants with mental disorders,26.12%(1047/4008)had moderate to severe functional impairment and 10.98%(428/3898)have sought professional help.Conclusion The prevalence of mental disorders among people aged 18 and above in Shandong Province is basically consistent with the results of similar domestic studies.The prevalence of mental disorder was higher in men than in women and was not differ in participants living in urban and rural areas.Alcohol use disorder,major depressive disorder,non-specific anxiety disorder and non-specific depressive disorder are most common mental disorders.