聊城市精神疾病患者求医方式及其影响因素的调查研究

目的了解聊城市≥18岁人群中各类精神疾病患者的求医方式及其影响因素，为制定精神卫生规划提供科学依据。方法2004年11月至2005年3月采用阶段性分层整群抽样的方法，随机抽取聊城市4个县（区）、8个乡镇（街道）、33个自然村（居委会）4800名≥18岁的人群为调查对象，使用一般健康问卷（GHQ-12）、精神发育迟滞／痴呆诊断量表（MMSE）、求医方式表作为筛查工具，以SOD-P和美国精神学会诊断手册第4版（DSM-Ⅳ）为诊断工具。结果共完成筛查4788人，精神疾病时点患病率为14．2％，总患病率为15．3％；求医方式首选综合医院内科、神经科门诊者占62．9％，求助于迷信巫术占18．2％，个体中西医诊所占8．8％，求助于精神科专业机构占4．4％；患者求医方式主要受文化程度、路途远近、发病形式及疾病特征、监护人及社会态度、对疾病知识了解程度、医方解释诊疗方式等因素的影响。结论加强综合医院、社区卫生机构与精神卫生专业机构的合作，提高非专科医生对精神疾病的诊断和识别能力，同时对精神疾病患者求医方式给予指导，是促使精神疾病患者早期正确就医、早日康复的重要策略。

Investigation of treatment of patients with mental disorders in Liaocheng

Objective To investigate the status of treatment of patients with mental disorders in Liaocheng and the impact factors for medical intervention of mental illness. Methods From November 2004 to November 2005, 4800 ≥ 18-year-old population were enrolled from four counties (districts), eight townships (streets), 33 villages(neighborhood committees). General health questionnaire(GHQ-12), mental retardation/dementia diagnosis Scale(MMSE), clinical registration forms, such as SCID-P and the spirit of the United States Institute of DSM-IV diagnosis(DSM-IV) were used as diagnostic tools. Results Four thousand seven hundred and eighty-eight people completed the survey. Mental illness prevalence rate was 14. 20%, with a total prevalence rate of 15.31%. The first way of seeking treatment is from the internal department and neurology department of general hospital, which accounts for 62.9% ;the second is to turn to superstition and magic,which accounts for 18.2% ;the third is from private clinic of Traditional Chinese and Western medicine,which accounts for 8.8% ;the last is from special psychi-atric department,which accounts for 4.4%. The ways are mainly influenced by the level of education, distance,the forms and characters of occurring illnesses, attitude of society, knowledge about this kind of illnesses and guidance of doctors. Conclusion The important strategies to seek treatment in a right way and become healthy in time are to strengthen the cooperation of general hospital , the communtity health service institutions and psychiatric health special bodies ;to improve the diagnoising and discerning ability of non-specialista and to give guidance to psychiatric about the ways.