河北省18岁及以上人群自杀未遂流行病学调查

目的:了解河北省自杀未遂的流行病学特点,分析自杀未遂的相关因素。方法:采用2004年10月至2005年3月河北省精神障碍流调样本,以该样本为多阶段分层整群抽样方法随机抽取≥18岁人群,共24000名,以回龙观医院北京心理危机与干预中心编制的自杀未遂调查表记录自杀未遂情况,用美国《精神障碍诊断和统计手册第四版(DSM-Ⅳ)》对各类精神障碍进行诊断。结果:(1)自杀未遂终生发生率为0.82%(95%CI:0.70～0.94);女性发生率为1.17%(95%CI:1.02～1.32),男性为0.47%(95%CI:0.38～0.56),女性明显高于男性(χ2=30.45,P0.001);城市发生率为0.45%(95%CI:0.36～0.54),农村为0.88%(95%CI:0.75～1.00),农村明显高于城市(χ2=5.26,P0.05)。(2)服毒药及治疗药为自杀的主要方式(78.2%),使用的药物或工具来源主要是放在家里(73.5%),最主要目的是解脱痛苦(73.5%),41.8%的自杀行为属冲动性,自杀未遂者中精神疾病患病率为52.9%。(3)Logistic回归分析显示:自杀未遂的危险因素为女性(OR=2.19,95%CI:1.55～3.09)、小学教育程度(OR=1.88,95%CI:1.34～2.65)、年龄30～39岁(OR=1.66,95%CI:1.19～2.34)、离婚(OR=3.28,95%CI:1.57～6.89)、再婚(OR=4.57,95%CI:2.00～10.46)、精神疾病(OR=8.72,95%CI:6.37～11.95)。结论:加强农药及治疗药的管理、及时发现、治疗精神疾病对自杀未遂的预防具有重要作用,应对自杀未遂人群进行有效干预,防止再次出现自杀行为。     

从55岁以上城乡居民MMSE得分特征上探讨其适用范围

目的 :探讨MMSE的适用人群及影响因素。方法 :通过随机整群分层抽样 ,对 4 92 1名 5 5岁或以上的西安市城乡居民进行MMSE测查。分析MMSE在不同人群中的得分特征对痴呆的阳性预测值和分析影响MMSE得分的因素。结果 :MMSE得分在不同年龄、不同文化程度、总体人群中都呈现负偏态 ,尖峭峰型分布。在年龄较轻 (70岁以下 )、文化程度偏高 (初中或以上 )的人群中偏态分布最明显 ,痴呆的检出率较低 ;而在年龄偏大 (70岁以上 ) ,文化程度偏低 (小学及以下 )的人群中接近正态分布 ,痴呆的检出率较高。年龄、性别、受教育年限、听力下降、日常生活能力对MMSE得分有显著影响。结论 :MMSE量表最适用于年龄偏大 (70岁以上 ) ,文化程度偏低 (小学或以下 )的人群 ,对痴呆的筛选能力大 ;而对于年龄偏小 ,文化程度偏高的人群 ,MMSE的鉴别筛选力较低。     

河南林县Alzheimer病危险因素的巢式病例对照分析

目的 :探讨河南林县阿尔茨海默病 (AD)的危险因素。方法 :采用年龄 (± 2岁 )、性别和乡别匹配的巢式病例对照研究方法分析 15年前的生活习惯、心理社会因素、躯体检查史和疾病史等对AD发生的影响作用。结果 :多因素模型中 ,高血压值OR =1 971、吃发霉蔬菜OR =1 767,皮肤病和贫血的疾病史OR值分别为 0 2 2 7和 0 5 34 ,且均存在显著性意义 ;高血压值的人群归因危险度为 2 8 3% ,与AD之间趋势检验P <0 0 0 0 2。结论 :在林县地区AD的发生中 ,高血压和吃发霉蔬菜为危险因素 ,而皮肤病和贫血的疾病史为保护因素 ;血压值与AD之间存在剂量 -反应关系。吸烟和饮酒未见与AD有显著性联系     

简易精神状态检查表在成都市不同区域55周岁及以上人群中的应用

目的： 研究中文版简易精神状态检查（ＣＭＭＳＥ） 在成都市不同区域５５周岁及以上人群中的应用及差异。方法：采用随机整群抽样方法从成都市五城区中抽取两个区,然后再从城中心和城郊场镇中各抽取２～３个居委会,并从两区所辖的农村抽取一个村进行调查。调查分为筛查和复查诊断两阶段。筛查用ＣＭＭＳＥ作筛查工具,复查诊断则用Ｐｆｅｆｆｅｒ功能活动量表和一组神经心理测验。结果： １２０１人完成了ＣＭＭＳＥ评定。发现男性ＣＭＭＳＥ评分显著高于女性, 城中心区被试者ＣＭＭＳＥ评分显著高于城郊场镇及农村被试者。在对文化程度的影响作校正后, 三组被试者ＣＭＭＳＥ评分差异仍有显著性。ＣＭＭＳＥ作为痴呆筛查工具对痴呆患者有较好的敏感性 （８９．７％ ） 和良好的特异性（９５．６％ ）, 而对认知功能损害的敏感性稍差（８４．６％ ）。学历、年龄、性别和日常生活功能对ＣＭＭＳＥ评分有显著影响。结论： 简易精神状态检查（ＭＭＳＥ） 是一简便、快捷, 在国内外应用广泛的痴呆筛查工具。但在设定ＭＭＳＥ认知损害划界分时, 除要注意受教育程度外, 应把不同的生活工作环境对ＭＭＳＥ评分的影响作为一重要因素加以考虑。     

天津市18岁及以上社区人群睡眠质量调查

目的:了解天津市18岁及以上居民睡眠质量及相关因素。方法:调查对象来源于2011年7月-12月进行的天津市精神障碍流行病学调查项目,有11618名18岁及以上社区居民完成匹兹堡睡眠质量指数量表(PSQI)对睡眠质量的评估,以及一般健康问卷(GHQ-12)对是否可能存在心理障碍的筛查。PSQI总分7分为低睡眠质量。用χ2检验分析各变量组间低睡眠质量检出率的差异,多因素logistic回归分析睡眠质量的相关因素。结果:11618人中低睡眠质量980人,调整后天津市低睡眠质量的检出率为6.6%。Logistic回归分析显示:女性(OR=1.47,95%CI:1.19~1.82)、年龄越大(30~39岁OR值1.72,95%CI:1.10-2.69;40~49岁OR值2.55,95%CI:1.66-3.91;50~59岁OR值4.41,95%CI:2.85-6.83;60~69岁OR值5.34,95%CI:3.32-8.59;70岁及以上OR值5.40,95%CI:3.21-9.08)、医疗花费为自费(OR=1.52,95%CI:1.15~2.00)、职业为失业/无业(OR=1.46,95%CI:1.05~2.03)或离/病退(OR=1.45,95%CI:1.02~2.06)、吸烟(OR=1.49,95%CI:1.22~1.83)、因躯体疾病难以从事日常工作或活动(OR=2.30,95%CI:1.85~2.85)、GHQ-12得分≥4分(OR=6.51,95%CI:5.46~7.46)为低睡眠质量的危险因素。结论:天津市18岁以上居民低睡眠质量的检出率虽然较同类研究低,但睡眠问题依然值得关注。女性、年龄较大、医疗自费、无职业、有躯体疾病及可能存在心理障碍是低睡眠质量的相关因素。     

昆明市0-17岁儿童先天性心脏病流行病学调查

目的 为了解本地区先天性心脏病的发病情况及发病原因,为防治先心病及优行工作提供科学依据。结果提示：本次调查先心病患病率为２．７３‰,患病率的高低随年龄而异,年龄越小患病率越高,６０％在６个月内发现。先心病可能的发病因素与母亲妊娠期先兆流产、呼吸道感染、感染风疹病毒、Ｘ线照射、孕早期服用四环素、感冒药、镇静剂及精神因素等有关。有先心病的胎儿出生后有出体重你、早产、窒息等情况。     

山东省18岁以上人群应对方式及影响因素现况调查

目的:调查了解山东省18岁以上人群的应对方式,分析影响人群应对方式的影响因素。方法:采用多阶段分层整群系统随机抽样法,抽取54个县(市、区)、98个街道(乡镇),共计98个村(居委会)的27913人,使用一般情况调查表和简易应对方式问卷(SCSQ)进行调查。结果:调查对象积极应对得分平均(1.68±0.82)分,消极应对得分平均(1.09±0.63)分;常住农村、45岁以上、躯体健康状况差、心理健康状况不好、睡眠质量差的人群倾向于选择消极的应对方式;男性、已婚、受教育年限在7年以上、有医疗保障人群的倾向于选择积极的应对方式。结论:城乡、性别、年龄、婚姻状况、受教育年限、医疗付费方式、身心健康状况及睡眠质量可能是应对方式的影响因素。建议多关注农村居住、女性、中老年人、低受教育程度等特征的重点人群。     

胎儿先天性畸形的调查结果统计及危险因素分析

目的 研究胎儿先天性畸形(CM)的调查结果并分析其危险因素.方法 将医院2017年1月-2019年1月诊断且确诊的103胎儿CM孕产妇作为研究组.分析胎儿CM分布情况.另取同期正常孕产妇100例作为对照组.比较两组孕产妇相关资料以及胎儿特性,以多因素Logistic回归分析明确胎儿CM的相关影响因素.结果 按照占比从高...     

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。     

简易精神状态检查适用人群及影响因素

目的：根据简易精神状态检查（MMSE）在大样本人群中的测试结果分析，探讨MMSE的适应人群及影响因素。方法：通过随机整群分层抽样，对4921名55岁或以上的西安市城市居民进行MMSE测查。分析MMSE得分在不同年龄，不同文化程度以及总体人群中的第10百分数、中位数、偏度、峰度以及对痴呆的阳性预测值。并用多元逐步回归法分析MMSE得分的影响因素。结果：MMSE得分在不同年龄、不同文化程度、总体人群中都呈现负偏态，尖峭峰型分布。在年龄较轻（70岁以下）、文化程度偏高（初中或以上）的人群中偏性分布最明显，痴呆的检出率较低；而在年龄偏大（70岁以上），文化程度偏低（小学及以下）的人群中接近正态分布，痴呆的检出率较高。文化程度、年龄、性别、受教育年限、听力下降、日常生活能力对MMSE得分有显著影响（P＜0．001）。结论：MMSE量表最适用于年龄偏大（70岁以上），文化程度偏低（小学或以下）的人群，对痴呆的筛选能力大；而对于年龄偏小，文化程度偏高的人群，MMSE的鉴别筛选力较低。实践中应根据具体研究目的选用适宜量表，并灵活掌握分界值，以达到最大效益。     

Psychological Factors and Mortality Risk in a Rural Area of Japan

Background

The purpose of this study is to assess the association between psychological factors and mortality risk from all causes.

Methods

We used follow-up data for 4,181 persons from 40 to 79 years over a period of 17.6 years from one part of the Japan Collaborative Cohort Study (JACC Study). The status of the individuals comprising the data of the study as of the end of December 2006 was determined from their registration cards and death records. We calculated the proportions of selected variables among 5 psychological factors by sex. Cox’s proportional hazards model was used to evaluate the associations between psychological factors and mortality risk from all causes. Data were adjusted for age, medical history, education, job status, marital status, drinking, smoking, physical activity, sleeping duration, body mass index and breakfast.

Results

During the follow-up period, a total of 791 deaths were recorded. Men who reported feelings of being trusted had a decreased risk for mortality risk from all causes compared with the risk of those who reported “maybe”, whereas those without feelings of being trusted had increased risk for mortality risk from all causes.

Conclusion

This study suggests that the absence of feelings of being trusted increases the risk of all causes of mortality among middle-aged and elderly men in a rural area. Our findings suggest that interpersonal relationships comprise an important factor in longevity.     

河北农村幼儿女教师心理健康状况及其影响因素

本文以河北农村幼儿教师学前教育基地进行培训的 98级、 99级、 2 0 0 0级学员中随机整群抽取 3 0 0人为调查对象 ,收回 3 0 0份 ,有效问卷 2 83份。都是女性 ,年龄为 19-4 1岁 ,平均为2 8 2 4± 3 0 5岁。采用　 1 自拟个人情况调查表　包括年龄、性别、民族和地区受教育程度     

Association between Serum 25-Hydroxyvitamin D Level and Insulin Resistance in a Rural Population

Purpose

A low serum 25-hydroxyvitamin D [25(OH)D] level in the blood has been correlated with an increased risk of diabetes mellitus; however, the association between serum 25(OH)D level and insulin resistance has not been established in a Korean rural population. The aim of this study was to investigate the independent association between serum 25(OH)D level and insulin resistance in rural Korean adults.

Materials and Methods

This study used data from the Korean Genome Epidemiology Study-Kangwha Study. In the 2011 study, 1200 adults completed health examinations. In an ancillary study, serum 25(OH)D level was measured in a subsample (n=813). After excluding those taking vitamin D supplements, a cross-sectional analysis was carried out on 807 participants (324 men and 483 women) aged 40 to 89 years old. Measured from overnight fasting blood samples, glucose and insulin levels were used to calculate the homeostasis model assessment for insulin resistance (HOMA-IR). Measures of glucose, insulin, and HOMA-IR were log-transformed for parametric tests.

Results

Serum 25(OH)D level was inversely associated with HOMA-IR (β=-0.003, p=0.039) in a univariate analysis. However, the association was not significant after adjustment for sex and age (β=-0.002, p=0.123) or after adjustment for sex, age, body mass index, smoking status, alcohol intake, and regular exercise (β=-0.003, p=0.247).

Conclusion

Our findings suggest that vitamin D is not independently associated with insulin resistance in Korean men and women.     

Resurgence of Diphtheria in Rural Areas of North Karnataka,India

Background: A diphtheria outbreak was identified from Vijayapura (formerly Bijapur) district in the South Indian state of Karnataka in 2011. There was a surge in the number of throat swab samples received under the Integrated Disease Surveillance Programme (IDSP) in North Karnataka since then. Objectives: A microbiological study was undertaken to generate information on the status of resurgence of the disease in the region. Materials and Methods: Throat swabs from 432 suspected cases of diphtheria during 2012–2015 were obtained from government hospitals and primary health centres of 8 districts in North Karnataka and were processed for the culture and identification of Corynebacterium diphtheriae. Polymerase chain reaction for the presence of toxin gene (toxA and toxB) was carried out on the isolates. Antibiotic sensitivity tests were performed on the isolates with a panel of 14 antibiotics. Results: Thirty-eight (8.79%) out of 432 samples yielded C. diphtheriae on culture. All isolates possessed the diphtheria toxin gene. Out of the 38 confirmed cases, whereas 21 (55.26%) were between 1 and 5 years of age, 14 (36.84%) were aged between 5 and 10 years. Male children were three times more than females in confirmed cases. No information was available on the immunisation status of the cases. Emergence of resistance to penicillin was found with minimum inhibitory concentration reaching up to 6.00 μg/ml. Conclusion and Discussion: Our study identified an upsurge in cases of diphtheria in North Karnataka, particularly in Vijayapura District, and to the best of our knowledge, reports the emergence of penicillin resistance for the first time in India. The study calls for enhanced surveillance for the disease, making antidiphtheritic serum available in key hospitals in the region and serves to provide a baseline for future assessment of the impact of the recently launched ‘Mission Indradhanush’ programme in strengthening Universal Immunisation Programme (UIP).     

Insomnia as a risk factor for ill health: results from the large population‐based prospective HUNT Study in Norway

Insomnia co‐occurs with many health problems, but less is known about the prospective associations. The aim of the current study was to investigate if insomnia predicts cumulative incidence of mental and physical conditions. Prospective population‐based data from the two last Nord‐Trøndelag Health Studies (HUNT2 in 1995–97 and HUNT3 in 2006–08), comprising 24 715 people in the working population, were used to study insomnia as a risk factor for incidence of physical and mental conditions. Insomnia was defined according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV). Insomnia at HUNT2 was a significant risk factor for incidence of a range of both mental and physical conditions at HUNT3 11 years later. Most effects were only slightly attenuated when adjusting for confounding factors, and insomnia remained a significant risk factor for the following conditions in the adjusted analyses: depression [odds ratio (OR): 2.38, 95% confidence interval (CI): 1.91–2.98], anxiety (OR: 2.08, 95% CI: 1.63–2.64), fibromyalgia (OR: 2.05, 95% CI: 1.51–2.79), rheumatoid arthritis (OR: 1.87, 95% CI: 1.29–2.52), whiplash (OR: 1.71, 95% CI: 1.21–2.41), arthrosis (OR: 1.68, 95% CI: 1.43–1.98), osteoporosis (OR: 1.52, 95% CI: 1.14–2.01, headache (OR: 1.50, 95% CI: 1.16–1.95, asthma (OR: 1.47, 95% CI: 1.16–1.86 and myocardial infarction (OR: 1.46, 95% CI: 1.06–2.00). Insomnia was also associated significantly with incidence of angina, hypertension, obesity and stroke in the crude analyses, but not after adjusting for confounders. We conclude that insomnia predicts cumulative incidence of several physical and mental conditions. These results may have important clinical implications, and whether or not treatment of insomnia would have a preventive value for both physical and mental conditions should be studied further.     

Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a Healthy Population

PurposeTo determine the prevalence of and investigate the risk factors for gallbladder (GB) polypoid lesions in a healthy population.ResultsThe prevalence of GB polypoid lesions was identified as 9.96%. On multivariate analysis, chronic hepatitis B infection (CHB) and the presence of metabolic syndrome (MS) were risk factors for GB polypoid lesions. CHB and MS were also significant independent risk factors for multiple GB polypoid lesions when compared with solitary GB polypoid lesions. In addition, gastric Helicobacter pylori infection and MS were significant risk factors for GB polypoid lesions with stones when compared with GB polypoid lesions without stones.ConclusionThe prevalence of GB polypoid lesions in a healthy Korean population was 9.96%. Patients with CHB and MS need to be carefully examined for such lesions.