潍坊市精神疾病流行学十年对照研究

对潍坊市1984年精神疾病流行学调查样本区进行10年追踪调查发现,各类精神疾病患病率上升至15.04‰(1984年7.63‰)。5年平均发病率上升至0.92‰(1984年0.40‰)。以精神分裂症、精神发育迟滞和Alzheimer老年型患病率升高最为显著。     

广州战区精神疾病流行学和心理卫生调查分析

本文分析广州战区精神疾病的流行学调查资料，重精神病抽样１００３０人，总患病率为３．１９‰，现患病病率为１．９０‰，神经症抽样１９３９人，患病率为２６．８２‰，创伤后应激障碍的患病率为７．７４‰。心理卫生测查ＳＣＬ－９０结果与全国常模基本一致，性格特征Ｅ，Ｐ，Ｑ测查结果Ｅ分高于全国常模，Ｎ分低于全国常模。     

精神疾病流行学调查方法比较

为了解精神疾病流行学调查方法的有效性，作者以“精神卫生筛选表”为调查工具，用线索调查和逐户筛查的方法，对２２８３０户（７５９５６人）进行精神疾病流行学调查，同时采用“简易智力状态检查（ＭＭＳＥ）”对６５岁以上者见面筛查。结果显示：两种方法相比，逐户筛查的敏感性高于线索调查，在逐户筛查漏诊的８６例中，７５例由线索调查提供，其余漏诊的１１例老年期痴呆由ＭＭＳＥ见面筛查发现。在线索调查中老年期痴呆和精神发育迟滞的漏诊率均高于功能性精神疾病。提示流行学调查以线索调查和逐户筛查相结合为宜，对老年人采用专门的筛查工具逐人见面，可减少漏诊率。     

山东省精神疾病流行学抽样调查资料分析

为了解和掌握我省精神疾病流行情况和分布特征,提供制定防治规划的依据,我省于1984年7月在全省范围内进行了一次精神疾病流行学抽样调查,总结报告如下。调查前的准备为培训流行学调查业务骨干力量,我们于1982年7月举办了一期防治医师学习班,系统地学习了全国十二地区精神疾病     

威海市精神疾病流行病学调查

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。     

马钢桃冲矿精神疾病流行学调查

马钢桃冲矿总人口为４７４０人。１９９７年１０月笔者等抽样调查了该区９０户计３４３人，现将有关资料报告如下：１　方　　法调查者要求从事精神科工作５年以上的主治医师，各种调查表的使用经反复测试，一致性达８８％。其方法与步骤：（１）得到矿区领导和职工医院的支持和协助。（２）调查前通过矿有线电视台进行宣传。（３）抽样户均经精神卫生筛选表、神经症筛选表、儿童智力筛查测验表、社会功能缺陷筛选表、精神卫生调查表、精神发育调查表、人格障碍调查表和神经症病史调查表等逐一面检［１］。并抽取２０％阴性人数以ＰＳＥ８７…     

淮阴地区精神分裂症流行学调查资料分析

对淮阴地区精神分裂症流调资料分析，发现精神分裂症的患病率为３．１％，与７０年１‰相比，呈增高趋势。无职业、离异、大家庭型人口中患病率较高。预后同诸多因素无明确相关。对精神分裂症患者生活事件行量表评定，显示病前多有严重生活事件遭遇。社会功能缺陷评定提示患者的社会劳动能力多有不同程度损害。     

精神疾病抽样调查及精神分裂症社会功能缺陷评定—10年对照

1982年徐汇区作为全国12个地区精神疾病流行学调查的试点单位之一，其抽样调查资料结果与1993年本批人群10年后对照，精神疾病的患病率有明显上升趋势，但是，精神分裂症的社会功能水平有所改善。     

精神疾病误诊160例资料分析

目的：探讨精神疾病最常见的误诊因素对诊疗的影响,以利提高诊疗水平,降低误诊率。方法分为误诊组和确诊组,用自行设计的调查表收集造成误诊的可能工通过统计筛查出其中最主要的因素。结果：两组在行为障碍,妄想、精神检查详细度,各组医师对症状认识一致性,诊断一致性、诊断标准符合上存在显著差异,结论精神疾病的主要误诊因素是病史采集不详细、精神检查粗浅,对症对认识的不一致以及对诊断标准把握上的差异造成。     

Case identification in psychiatric epidemiology: A review

Background: Psychiatric epidemiologic surveys since 1980 have relied heavily on a small number of survey diagnostic instruments for case ascertainment, which encode reports of respondents to highly structured interview questions delivered by interviewers without clinical training. Many validations of these survey diagnostic instruments have been carried out.

Objective: This paper reviews the success of the survey diagnostic instruments, for eight diagnostic categories, in validations with a psychiatrist examination as the gold standard.

Method: Public databases were searched for potentially relevant publications, of which more than 1000 were located. Tables show sensitivity, specificity, Kappa, sample source and size, survey instrument and validation method.

Results: The number of validation studies relevant to the eight disorders ranged from 8 for schizophrenia to 29 for major depressive disorder. Reported sensitivities ranged from zero to 100%, and specificities from 22% to 100%.

Conclusion: Results for common mental disorders such as major depressive disorder, alcohol disorder, drug disorder, and agoraphobic disorder are better than for panic disorder, obsessive compulsive disorder, bipolar disorder, and schizophrenia. The validity of case ascertainment in psychiatric epidemiology is still in question.     

Survey of psychiatric morbidity in a semi-urban population in Sri Lanka

This paper reports a survey of psychiatric morbidity in a semiurban community (population 7,653) in Sri Lanka. The entire population was first screened by social workers using a standardized interview. Probable cases were then examined by psychiatrists. Each psychiatric disorder identified was rated on four different parameters of severity, and only those rating moderate or severe were labelled as cases. The socio-demographic characteristics of the cases and the population at risk, and the frequency and nature of psychiatric disorders are presented in Tables. The 6-month period prevalence for all psychiatric disorders was 45.5 per 1,000, with psychoses amounting to 6.9 (males 5.5; females 8.4) per 1,000, and neuroses to 25.2 (males 9.9; females 40.6) per 1,000. The large majority of disorders were chronic and had not received psychiatric treatment. The relevance of these surveys in the provision of psychiatric services in developing countries is discussed.     

垂体微腺瘤与精神障碍附8例临床分析

目的： 探讨垂体微腺瘤伴发精神障碍的临床表现及诊断。　方法： 收集近１３ 年的住院病历共１５ ４４８ 份, 发现垂体微腺瘤伴发精神障碍者６例, 占０．３９‰; 门诊病人２ 例。对临床表现和诊断进行分析。　结果： ８ 例病人均为女性, 年龄１８～３０ 岁, 平均 （２５．３±１．３） 岁; 病程０．７５～１３ 年,平均（４．８±１．５） 年。首发症状６ 例为内分泌失调, ２例为精神障碍。精神障碍表现抑郁状态２例, 躁狂发作２例, 双相情感障碍１ 例, 精神分裂症样症状２ 例, 精神分裂症样和情感症状混合状态１ 例。　结论： 垂体微腺瘤伴精神障碍的临床表现多种多样, 鉴别诊断中应予以注意。     

Linkage studies of psychiatric disorders

Summary Linkage analysis has been successful in identifying the genetic basis of numerous Mendelian diseases. These successes were due in part to the rapid developments in molecular biology, which have yielded a plethora of informative genetic markers. Although there is strong evidence that the manifestation of schizophrenia and bipolar affective disorders is controlled by genes, no evidence for linkage has been established. For psychiatric disorders, the most important limiting factor is likely to be the lack of single loci with very large effects that occur with any relevant frequency. The difficulties of linkage studies in psychiatric disorders are discussed with reference to non-psychiatric genetic diseases for which linkage to genetic markers has been successful. Recommendations for collecting information to clarify the patterns of transmission of the psychiatric disorders are described.     

精神疾病司法鉴定中精神病患者防御方式结果对照分析

目的探索精神疾病司法鉴定中精神病患者的防御方式及与责任能力评定的关系。方法对2006年10月～2007年11月进行的精神疾病司法鉴定案例中的被鉴定人进行一般资料收集、责任能力判断、防御方式测查,共收集精神病患者70例,正常者34例。然后,进行对照分析。结果精神病患者与正常者之间在防御方式结果上无显著差异,分值均较高。结论进行精神疾病司法鉴定的被鉴定人有类似的防御方式。在司法鉴定阶段,防御方式测试是一个不敏感的测试工具。     

READMIT: A clinical risk index to predict 30-day readmission after discharge from acute psychiatric units

Our aim was to create a clinically useful risk index, administered prior to discharge, for determining the probability of psychiatric readmission within 30 days of hospital discharge for general psychiatric inpatients. We used population-level sociodemographic and health administrative data to develop a predictive model for 30-day readmission among adults discharged from an acute psychiatric unit in Ontario, Canada (2008–2011), and converted the final model into a risk index system. We derived the predictive model in one-half of the sample (n = 32,749) and validated it in the other half of the sample (n = 32,750). Variables independently associated with 30-day readmission (forming the mnemonic READMIT) were: (R) Repeat admissions; (E) Emergent admissions (i.e. harm to self/others); (D) Diagnoses (psychosis, bipolar and/or personality disorder), and unplanned Discharge; (M) Medical comorbidity; (I) prior service use Intensity; and (T) Time in hospital. Each 1-point increase in READMIT score (range 0–41) increased the odds of 30-day readmission by 11% (odds ratio 1.11, 95% CI 1.10–1.12). The index had moderate discriminative capacity in both derivation (C-statistic = 0.631) and validation (C-statistic = 0.630) datasets. Determining risk of psychiatric readmission for individual patients is a critical step in efforts to address the potentially avoidable high rate of this negative outcome. The READMIT index provides a framework for identifying patients at high risk of 30-day readmission prior to discharge, and for the development, evaluation and delivery of interventions that can assist with optimizing the transition to community care for patients following psychiatric discharge.     

癫痫患者违法的司法精神医学鉴定分析

目的　研究癫痫患者违法的特点和刑事责任能力。方法　回顾性分析 3 6例癫痫患者违法的司法精神医学鉴定资料。结果　发现癫痫患者发生违法行为仅次于精神分裂症和精神发育迟滞 ,其违法行为以凶杀和伤害居首位 ,其次为妨碍社会治安和强奸 ,反社会言行和纵火偶见。提出了他们违法的特点和刑事责任能力评定原则。结论　癫痫患者发生违法行为是癫痫患者的一大危险 ,应加强对癫痫患者的治疗和管理工作。     

精神科门诊疑难病例的临床分析

目的了解精神科门诊疑难病例的临床特点和规律性。方法回顾性分析武汉市精神卫生中心门诊1997年8月-2005年9月390例病例讨论登记资料,选择资料较完整的100例进行分析。结果（1）精神科门诊疑难病例的范围,临床相与病种虽较广泛,但功能性精神疾病之间的鉴别诊断是主要的占72.6%;（2）分析了不易确诊的主要原因是病史资料不全,精神状况检查欠深入及病历资料分析方面存在问题;（3）分析了疑难病例讨论的效果,从随访诊断中比较了首次门诊、病例讨论前最后一次门诊和病例讨论时的诊断符合率,有逐步上升的趋势,分别为18%、44%和89.6%。并且比较了病例讨论前后的治疗效果,病例讨论前显效率为7.4%,有效率为26.3%,病例讨论后的显效率37.8%,有效率67.1%。结论及时和定期地组织疑难病例讨论和随访,有利于提高门诊医疗工作质量,提高诊断符合率和治疗效果。     

精神科护士心理健康状况与应付方式的相关因素分析

目的　探讨精神科护士心理健康状况及影响其应付方式的相关因素。方法　应用症状自评量表(SCL - 90 )、应付方式问卷及艾森克个性问卷对 2 88名精神科护士进行评定。结果　精神科护士SCL 90各因子分均高于国内常模 ,躯体化、人际关系敏感、焦虑和敌对四项因子有显著性差异 (P <0 .0 1) ,应付方式与个性心理特征相关性较大 ,与年龄、护龄不呈线性关系 ,与是否倒班无关。 4 - 8年护龄的护士应用解决问题应付方式比其他护龄组明显减少。结论　应加强对精神科护士心理疏导 ,尤其是对工作 4 - 8年护士应付方式的指导。