乌鲁木齐市心境障碍现况调查

目的:描述乌鲁木齐市18岁及以上人群心境障碍的患病率及分布特征。方法:计算乌鲁木齐市精神卫生调查的各类心境障碍加权终生患病率及12月患病率,采用χ²检验比较心境障碍终生患病率及12月患病率的性别、年龄、婚姻状态、受教育程度及收入水平分布的差异。结果:共调查1782人,心境障碍终生患病率及12月患病率分别为5.54%和2.60%。抑郁障碍未特定患病率最高,其次是抑郁症,双相障碍的患病率最低。心境障碍12月患病率年龄和收入水平分布的差异有统计学意义(P<0.05),65岁及以上人群12月患病率高于35～49岁人群(9.90%vs.1.54%),高收入人群12月患病率高于低收入人群(5.19%vs.0.99%)。心境障碍终生患病率年龄分布的差异有统计学意义(P<0.001),18～34岁和65岁及以上人群(分别为8.36%和13.70%)的终生患病率高于35～49岁和50～64岁人群(分别为1.71%和2.48%)。结论:65岁及以上老年群体、18～34岁青年群体以及高收入群体心境障碍患病率较高,是应当重视的高危人群,社区中的抑郁障碍未特定类别的患者应予以关...     

基诺族抑郁症的流行病学调查

目的:了解云南省景洪市基诺族抑郁症的患病情况及相关因素。方法:本研究为横断面研究。采用按比例单纯随机抽样原则抽取基诺族1977名15岁及以上的基诺族居民,采用自编的一般情况调查表、一般成人健康问卷(GHQ)进行精神疾病筛查,采用DSM-IV-TR轴I障碍定式临床检查病人版(SC ID-I/P)进行诊断,对抑郁症患者进行汉密尔顿抑郁量表(HAMD17)评分。结果:基诺族的抑郁症时点患病率为2.4%,女性患病率明显高于男性(4.0%vs.1.0%,P<0.001),各年龄段中以35~54岁组的患病率3.7%为最高,受教育年限多者患病率高于受教育年限低者(3.2%vs.1.4%,P<0.05);女性、目前工作状况不佳、缺乏家人理解以及存在自杀意念的人群抑郁症患病率较高;女性患者的HAMD得分较男性高,家人支持差者的HAMD得分较家庭支持好者高。结论:基诺族抑郁症的患病率与近年国内其他省市报告的患病率相近,在性别、年龄、受教育程度方面存在差异,以女性35~54岁人群和受教育程度较高者的患病率相对更高。     

西安市社区居民情感障碍的流行病学调查

目的:探讨西安市社区居民情感障碍的发生情况及其影响因素。方法:采用随机抽样方法抽取西安市≥16岁的2447人,应用中文版计算机辅助复合性国际诊断交谈检查表3.0(CIDI-3.0 CAPI)作为访谈工具进行流行病学调查,调查情感障碍的患病率,分析相关因素以及与自杀的关系。结果:西安市社区居民情感障碍的30天患病率为0.57%,12个月患病率是2.37%,终生患病率是4.33%,单因素和多因素分析显示离异/分居/丧偶是情感障碍的危险因素(χ2=21.052,P=0.000)。情感障碍患者具有自杀计划(χ2=29.166,P=0.000)和自杀行为(χ2=45.377,P=0.000)的危险。结论:西安市社区居民情感障碍的患病率与国内其他研究结果相近,显著低于国外的患病率,离异/分居/丧偶人群具有较高的患病风险,对情感障碍患者采取及时有效的干预对自杀的预防具有重要意义。     

乌鲁木齐市焦虑障碍现况调查

目的:描述乌鲁木齐市社区居民焦虑障碍的患病率及其分布。方法:用现况调查多阶段分层抽样方法,2013年抽取乌鲁木齐市18岁及以上社区居民2178名,采用复合性国际诊断交谈表-3.0(CIDI-3.0)进行入户访谈,根据美国精神障碍诊断与统计手册第4版标准对焦虑障碍进行诊断。计算各类焦虑障碍12月患病率及终生患病率,采用χ²检验比较焦虑障碍患病率在不同性别、年龄、婚姻状态、受教育程度及收入水平分布的差异。结果:共1782人完成CIDI访谈,焦虑障碍加权终生患病率和12月患病率分别为6.50%和5.23%。患病率居前3位的类别分别为强迫障碍(4.77%)、特殊恐怖症(0.46%)和社交恐怖症(0.01%)。焦虑障碍终生患病率和12月患病率的性别、年龄、婚姻状态、受教育程度、收入水平分布的差异无统计学意义。结论:乌鲁木齐市社区居民焦虑障碍12月患病率较高。     

乌鲁木齐市4类精神障碍危险因素

目的:探讨乌鲁木齐市社区成人4类精神障碍的危险因素。方法:本调查作为中国精神卫生调查的一部分,采用抽样调查的方法获得乌鲁木齐市4类精神障碍终生患病率和12月患病率及其分布特征,运用logistic回归分析探索4类精神障碍的相关因素。结果:共1782人完成调查,共调查出心境障碍、焦虑障碍、酒精药物使用障碍和进食障碍4类精神障碍患者,终生符合4类精神障碍任一诊断的病例数为87例,4类中任何一类精神障碍终生患病率为11.41%,12月患病率为7.64%。心境障碍终生患病的危险因素有大学及以上受教育程度(OR=4.80,95%CI:1.57～14.69)、无工作(OR=13.13,95%CI:1.75～98.72)、罹患躯体疾病(OR=17.13,95%CI:4.28～73.42);心境障碍12月患病的危险因素有高收入水平(OR=5.32,95%CI:1.38～20.47)、罹患躯体疾病(OR=75.53,95%CI:1.23～999)。焦虑障碍终生患病的危险因素有初中(OR=19.37,95%CI:1.75～214.04)和大学及以上(OR=13.04,95%CI:1.48～114.85)受...     

浏阳市农村抑郁症患病影响因素分析

目的:探讨农村社区人群抑郁症患病影响因素.方法:采用分层多级随机抽样方法,共完成调查7347人,以SCID-I/P为诊断工具,共筛查出抑郁症患者295例,全部符合DSM-IV诊断标准.以同人群中未患抑郁症者7052人为正常对照组.结果:女性患病率(4.6%)高于男性(3.2%);不同年龄组间患病率的比较,以45岁～75岁中老年人群患病率较高.多因素Logistic回归分析结果,抑郁症的患病影响因素有性别为女性(OR=1.334,95%CI:1.040～1.711)、年龄(OR=1.012,1.002～1.022)、受教育程度较低(OR=1.428,1.048～1.946)、职业为农业劳动者(OR=1.490,1.050～2.115)、不稳定婚姻状况(OR=1.628,1.174～2.260)、低收A(OR=1.361,1.066～1.737)、常住人口数(OR=1.132,1.042～1.230)、现患躯体疾病(OR=3.020,2.345～3.888)等.结论:浏阳市农村居民抑郁症患病影响因素主要有性别、年龄、低受教育程度、工作为农业劳动者、不稳定婚姻状况、低收入和现患慢性躯体疾病等.     

临床干预是自杀预防的重要一环

<正>自杀一直是非常严重的公共卫生问题。2010年,自杀在死亡原因中排第10位,其中在24岁及以下人群中,占死亡原因的第3位。有研究结果提示,情感障碍患者中,曾因自杀住院的个体,自杀的终生患病率为8.6%,而非自杀情感障碍患者中,自杀终生患病率为4.0%;精神分裂症患者中,自杀的终生患病率为4.9%,除此,物质依赖患者中出现自杀的比例也很高。值得引起注意的是,美国军人中的自杀率已超过普通人群,在自杀     

北京城乡老年人轻度认知障碍患病率调查

目的：调查北京地区老年人群轻度认知功能障碍（MCI）的患病率,分析患病的相关因素。方法：采用逐户访问方式,抽样调查了北京城乡社区60岁及以上老年人1865例,调查分为2个阶段,第1阶段筛查,由经过培训的调查员完成调查问卷及记忆量表、生活活动能力量表（ADL）及认知量表（MMSE）等测验。第2阶段临床诊断,由神经科专科医师对有主诉或家属诉其有明显记忆障碍者,及或有MMSE分数低于界值者进行病史收集、临床体格检查和神经心理测验,并由两名医师最后做出诊断。结果：1865例60岁及以上老年人中有MCI者217人,占11.6%,标化患病率为8.9%。患有MCI的老人中,22.6%为血管性因素所致（MCI-V）。MCI患病率在农村地区、低教育水平及体力劳动为主的老年人群中增加,随年龄增长,患病率增高。结论：与痴呆的患病特征相同,高龄、低教育水平、居住在农村的老年人是MCI的高发人群。     

昆明市15岁及以上居民自杀相关问题现况调查

目的:了解昆明市居民自杀问题的检出率及其相关因素。方法:按照分层容量比例概率随机抽样法,以昆明市≥15岁5033人为调查对象。在复合性国际诊断交谈检查2.1版(Composite InternationalDiagnostic Interview-version2.1,CIDI-2.1)回答后进行自杀相关问题调查,并分析人口学相关危险因素。结果:调查5033人中有自杀意念者占5.89%(95%CI,5.24%～6.54%),计划自杀1.71%(95%CI,1.35%～2.06%),曾有过自杀行为者0.76%(95%CI,0.52%～1.00%)。女性自杀意念、自杀计划及行为的发生率均高于男性(7.50%vs.4.15%,2.65%vs.0.84%,1.32%vs.0.24%;均P0.001)。城镇居民更易出现自杀意念(6.27%vs.3.42%;P0.001);离婚、分居、丧偶、受教育程度低者更易出现自杀计划(P0.05)。各年龄段、汉族和少数民族自杀问题检出率差异无统计学意义。患有焦虑障碍、物质使用障碍、情感障碍、躯体形式障碍者多易出现自杀相关行为。结论:昆明市居民中自杀问题突出,患有几类精神障碍是发生自杀问题的危险因素,应针对自杀行为进行有效干预。     

开滦集团男性乙肝病毒感染人群糖尿病患病率及其影响因素

目的探讨开滦集团乙肝病毒感染人群中糖尿病的相关影响因素。方法采用横断面的研究方法,以2006年至2007年81 110名在开滦集团体检的男性职工中乙肝表面抗原阳性人群为研究对象,描述并比较不同特征人群糖尿病患病率差别并探讨影响糖尿病的因素。结果在参加体检的男性人群中,2 276名乙肝表面抗原阳性[平均年龄为(49.5±11.7)岁],其中糖尿病患者192例,患病率为8.4%。多因素Logistic回归分析发现年龄(40～49岁:OR=2.78,95%CI:1.52～5.09,P0.001;50～59岁:OR=2.66,95%CI:1.46～4.85,P0.001;≥60岁:OR=4.69,95%CI:2.49～8.86,P0.001)、有糖尿病家族史(OR=3.44,95%CI:1.96～6.05,P0.001)、脂肪肝(OR=2.02,95%CI:1.46～2.80,P0.001)、肝硬化(OR=2.25,95%CI:1.02～4.95,P0.05)和高血压(OR=1.76,95%CI:1.27～2.42,P0.001)病史者糖尿病的患病风险增加;而饮酒者糖尿病的患病风险降低(OR=0.71,95%CI:0.51～0.98,P0.01)。结论年龄、糖尿病家族史、脂肪肝、肝硬化和高血压为开滦集团男性乙肝病毒感染者糖尿病的危险因素,应针对高危人采取干预措施预防糖尿病的发生。     

成都地区55周岁及以上人群中抑郁症患病率调查

目的了解成都地区55周岁及以上人群中抑郁症患病率及其影响因素。方法本文采用分层随机整群抽样方法,从成都市所辖地区抽取10个区市县。按农业人口和非农业人口所占比例确定应查城乡55周岁及以上人口数。调查由两阶段组成,先用流调用抑郁自评量表(CES-D)筛查,然后用DSM-Ⅲ-R定式临床检查(SCID-P)进行诊断复查。应查5587人,实查5385人,其中5350人完成了CES-D检查,35人因耳聋(且不识字),失语无法完成CES-D,改用SCID-P询问家属或其他知情者。外出171人,拒查31人,漏查率3.6%。结果发现CES-D评分≥16分者168人,为被调查人口的3.14%。诊断复查发现各类抑郁症的患病率分别为适应性障碍0.85%。心境恶劣障碍0.76%,躯体疾病所致抑郁心境0.52%,重型抑郁症0.45%。各类抑郁症总患病率为2.62%,其中男性1.60%,女性3.54%,女性患病率显著高于男性。多元逐步回归分析表明日常生活能力受损、女性以及认知功能下降老人有抑郁症状者较多。结论本文结果表明我国抑郁症患病率较低。适应性障碍,心境恶劣障碍和躯体疾病引起的抑郁是主要的抑郁类型。     

Affective disorders in five United States communities

Results on the age/sex specific prevalence of DSM-III affective disorders from the NIMH Epidemiologic Catchment Area Study (ECA), a probability sample of over 18,000 adults from five United States communities, are presented. The cross-site means for bipolar disorder ranged from 0.7/100 (2 weeks) to 1.2/100 (lifetime), with a mean age of onset of 21 years and no sex difference in rates. The cross-site means for major depression ranged from 1.5/100 (2 weeks) to 4.4/100 (lifetime), with a mean age onset of 27 years and higher rates in women. The cross-site means for dysthymia, a chronic condition, was 3.1/100 with a higher rate in women. There was reasonable consistency in prevalence rates among sites. The implications of these findings for understanding psychopathology are discussed.     

Late onset dysthymic disorder and major depression differ from early onset dysthymic disorder and major depression in elderly outpatients

BACKGROUND: Age of onset may affect clinical features and prognosis in elderly patients with major depression (MDD), but there is a lack of such data in elderly patients with dysthymic disorder (DD) and systematic comparisons of late onset MDD and DD have not been conducted. METHODS: In a Late Life Depression Clinic, patients > or = 60 years old who met DSM-III-R or DSM-IV criteria for MDD or DD were studied. The 24-item Hamilton Rating Scale for Depression (HRSD) and SCID-P were completed, family history was obtained, and medical illnesses were assessed. RESULTS: In the total sample (n=370; 211 MDD and 159 DD), compared to early onset patients, late onset (onset > or =60 years) patients had a higher rate of cardiovascular disease (chi(2)=4.12, df=1, P<0.05), lower rate of anxiety disorder (chi(2)=4.19, df=1, P<0.05), and a lower rate of family history of affective disorder (chi(2)=9.37, df=1, P<0.002). Late onset DD patients were more likely to have cardiovascular disease than early onset DD patients (chi(2)=5.63, df=1, P<0.02), but the rate of cardiovascular disease did not differ between late and early onset MDD patients (chi(2)=0.35, df=1, P<0.6). Late onset MDD patients were less likely to have a family history of affective disorder than early onset MDD patients (chi(2)=10.71, df=1, P<0.001). Prevalence of anxiety disorders did not differ between the early and late onset MDD patients (chi(2)=0.07, df=1, P<0.79), but was more common in the early onset DD compared to the late onset DD patients (17.98% versus 4.29%, chi(2)=6.98, df=1, P<0.01). Late onset DD did not differ from late onset MDD in the rates of cardiovascular disease, anxiety disorders, and family history of affective disorder. Excluding patients with double depression (n=32) did not alter the cardiovascular or family history findings, but the difference in anxiety disorders between early and late onset DD patients was no longer significant. LIMITATIONS: Academic clinic sample results may not generalize to community populations. CONCLUSIONS: In the elderly, late-onset DD is typically different from early onset DD. Cerebrovascular disease appears to play a role in the etiology of late onset DD. The similarities between late onset DD and late onset MDD suggest a single condition along a continuum.     

Suicide in subtypes of primary major depression

Among 100 consecutive suicide victims with primary major depression at the time of their suicide, 46% were found to have had bipolar II depression, 1% bipolar I disorder and 53% non-bipolar major depression. Since the lifetime prevalence rates of bipolar II and bipolar I depressions are relatively low compared to primary major non-bipolar depression, the present findings suggest that bipolar II disorder gives a particularly high risk of suicide among the different subtypes of primary major affective illness. Fifty-nine percent of the patients had medical contact during the depressive episode, but the depression was frequently undiagnosed, untreated or undertreated. The implications of these findings for suicide prevention are discussed briefly.     

The prevalence of major depressive and bipolar disorders in Hungary Results from a national epidemiologic survey

In order to estimate the prevalence of affective disorders in Hungary a sample of the Hungarian adult population (18–64 years) selected at random was interviewed using the Diagnostic Interview Schedule (DIS) which generated DSM-III-R diagnoses. The lifetime rate for Major Depressive Disorder (MDD) was 15.1%, and for Bipolar Disorders (BD) 5.1%. The female-to-male ratio was 2.7 for MDD and nearly equal for BD. The 1-year and 1-month period prevalence rates were 7.1% and 2.6% for MDD and 0.9% and 0.5% for manic episodes. A higher rate of divorced or separated persons was found among individuals with a lifetime diagnosis of MDD. Besides these, the lifetime diagnosis of BD coexisted with higher rates of the never-married state. The highest hazard rate for the development of BD or MDD was in the range 15–19 years but in MDD another peak was also found in the range 45–50 years. The first peak was characteristic of the recurrent, and the other one of the single form of MDD. Insomnia, loss of energy, decreased interest, concentration problems were the most common symptoms during the depressive episode, independent of polarity. Higher rates of lifetime diagnosis of dysthymia and all kinds of anxiety disorder were revealed among persons with MDD. BD was associated with GAD (Generalized Anxiety Disorder), and panic disorder more often than chance.     

Winter is coming: nightmares and sleep problems during seasonal affective disorder

Sleep problems, especially nightmares and insomnia, often accompany depression. This study investigated how nightmares, symptoms of insomnia, chronotype and sleep duration associate with seasonal affective disorder, a special form of depression. Additionally, it was noted how latitude, a proxy for photoperiod, and characteristics of the place of residence affect the prevalence of seasonal affective disorder and sleep problems. To study these questions, data from FINRISK 2012 study were used. FINRISK 2012 consists of a random population sample of Finnish adults aged 25–74 years (n = 4905) collected during winter from Finnish urban and rural areas spanning the latitudes of 60°N to 66°N. The Seasonal Pattern Assessment Questionnaire was used to assess symptoms of seasonal affective disorder. Participants with symptoms of seasonal affective disorder had significantly increased odds of experiencing frequent nightmares and symptoms of insomnia, and they were more often evening chronotypes. Associations between latitude, population size and urbanicity with seasonal affective disorder symptoms and sleep disturbances were generally not significant, although participants living in areas bordering urban centres had less sleep problems than participants from other regions. These data show that the prevalence of seasonal affective disorder was not affected by latitude.     

DSM-IV generalized anxiety disorder in the Australian National Survey of Mental Health and Well-Being

BACKGROUND: This paper reports population data on DSM-IV generalized anxiety disorder from the Australian National Survey of Mental Health and Well-Being. METHODS: The data were obtained from a nationwide household survey of adults using a stratified multi-stage sampling process. A response rate of 78.1% resulted in 10,641 persons being interviewed. Diagnoses were made using the Composite International Diagnostic Interview. The interview was computerized and conducted by trained lay interviewers. RESULTS: Prevalence in the total sample was 2.8% for 1-month GAD and 36% for 12-month GAD. Persons over 55 years of age were less likely to have GAD than those in the younger age groups. Logistic regression analysis also showed that a diagnosis of GAD was significantly associated with being of younger to middle age, being separated divorced or widowed, not having tertiary qualifications or being unemployed. Co-morbidity with another affective, anxiety, substance use or personality disorders was common, affecting 68% of the sample with 1-month DSM-IV GAD. GAD was associated with significant disablement, and 57% of the sample with DSM-IV GAD had consulted a health professional for a mental health problem in the prior 12 months. CONCLUSIONS: The survey provides population data on DSM-IV GAD and its correlates. GAD is a common disorder that is accompanied by significant morbidity and high rates of co-morbidity with affective and anxiety disorders, and is associated with marital status, education, employment status, but not sex. Changes to DSM-IV diagnostic criteria did not appear to affect the prevalence rate compared to previous population surveys.     

Major depression in cardiology chest pain patients without coronary artery disease and with panic disorder

104 patients in a cardiology clinic with atypical or non-anginal chest pain were studied through a structured clinical interview. 43 without coronary artery disease fit diagnostic criteria for panic disorder. 19 (44%) of this group reported a lifetime prevalence of major depression, nine (21%) current and ten (23%) past only. Nine reported that their major depressive episodes had preceded the onset of their panic disorder. On many self-report questionnaire scales the group with a lifetime history of major depression (n = 19) differed significantly from the group with no lifetime history of major depression (n = 24). These differences, however, could be attributed primarily to the group with current major depression. There appears to be a subgroup of panic disorder patients who have current major depression who are more symptomatic than those with panic disorder and past major depression and panic disorder alone. These findings also suggest that the association between panic disorder and depression may remain high outside of psychiatric settings.     

Anxiety disorders comorbidity in bipolar I, bipolar II and unipolar major depression: results from a population-based study in Hungary

BACKGROUND: The aim of this study was to analyze the lifetime comorbidity between DSM-III-R anxiety disorders in separate subgroups of patients with major depression, bipolar II and bipolar I disorder in a community sample of a Hungarian population. METHODS: Randomly selected subjects (aged between 18 and 64 years, N=2953) were interviewed by the Diagnostic Interview Schedule (DIS) which generated DSM-III-R diagnoses. RESULTS: The prevalence of generalized anxiety disorder, agoraphobia and simple phobia was the highest among bipolar II patients (20.8, 37.5 and 16.7%, respectively), social phobia was most prevalent in (nonbipolar) major depression (17.6%), while the rate of panic disorder was the same in the (nonbipolar) major depressive and bipolar II subgroups (12.4 and 12.5%, respectively). Bipolar I patients showed a relatively low rate of comorbidity. CONCLUSIONS: The findings support previous results on the particularly high rate of lifetime comorbidity between anxiety disorders and unipolar major depression and particularly bipolar II illness. LIMITATIONS: Underestimation of the prevalence of bipolar II disorder by the diagnostic methodology used, resulting in a small number of bipolar II cases, lack of analysis of data by gender, no data on obsessive-compulsive disorder.     

Affective disorders and depression as measured by the Diagnostic Interview Schedule and the Beck Depression Inventory in an unselected adult population

Rates, demographic correlates, and differential symptomatic expression as a function of gender of affective disorders and depression as measured by the Diagnostic Interview Schedule (DIS) and the Beck Depression Inventory (BDI) were examined in 298 paid adult volunteers selected by the random digit dialing method. According to the DIS, 7.7% were diagnosed as current affective disorder, 6% as current primary unipolar depression, 23.5% as lifetime affective disorder, and 19.5% as lifetime primary unipolar depression. According to the BDI, 19.8% scored depressed: 10.7% as mildly, 5.0% moderately, and 4.0% severely depressed, respectively. Of 11 demographic variables whose relation to DIS diagnoses were examined in a multivariate context, only occupation was correlated significantly with current primary unipolar depression. Of the same variables whose relation to BDI score was examined, education and race were correlated significantly with BDI score. There was no evidence of differential symptomatic expression as a function of gender as measured by lifetime diagnosis of primary unipolar depression on the DIS.