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...     

赤峰市成人抑郁症现况调查

目的:描述赤峰市抑郁症的患病率及其分布特点,并探讨相关危险因素。方法:以分层容量比例概率随机抽样的方法抽取赤峰市18岁及以上居民6376例,采用复合性国际诊断交谈表-3. 0-计算机版进行入户访谈,以美国精神障碍诊断与统计手册第4版为诊断标准诊断抑郁症。结果:4528人完成调查,抑郁症的加权终生患病率为4. 38%,加权12月患病率为1. 71%;抑郁症12月患病率女性高于男性(2. 11%vs. 1. 23%,P 0. 05),50～64岁年龄组高于18～34岁年龄组(2. 72%vs. 0. 92%,P 0. 01),≥65岁年龄组高于18～34岁年龄组(2. 65%vs. 0. 92%,P 0. 05);抑郁症首发年龄中位数为40 (4,80)岁;抑郁症患者求助精神科医生的比例仅为2. 4%。结论:赤峰市抑郁症患病率低于国外同类研究而与国内研究接近,女性及50岁以上群体有较高的患病风险。抑郁症患者求助精神科医生的比例不高,原因和对策值得进一步深入探讨。     

赤峰市18岁及以上人群焦虑障碍现况调查

目的:描述赤峰市焦虑障碍的患病率及其分布特点,并探讨相关危险因素。方法:2010年11月至2011年4月以多级抽样的方法在赤峰市≥18岁居民中取样,采用复合性国际诊断交谈表-3.0-计算机辅助访谈版(CIDI-3.0-CAPI)进行入户访谈,以美国精神障碍诊断与统计手册第4版(DSM-IV)为诊断标准诊断焦虑障碍,采用单因素和多因素分析进行统计分析。结果:4528人完成调查,焦虑障碍12月患病率农村高于城市(4.62%vs.2.61%,P0.01),女性高于男性(4.92%vs.2.82%,P0.01),未婚离异或丧偶者高于已婚者(5.91%vs.3.70%,P0.01)。Logistic回归分析结果显示,城市、受教育年限7~9年是焦虑障碍的保护因素,女性、未婚离异或丧偶是焦虑障碍的危险因素;焦虑障碍患者求助精神科医生的比例仅为3.1%。结论:焦虑障碍是赤峰市常见的一类精神障碍,而患者很少求助精神科医生。应该针对焦虑障碍开展精神卫生服务和知识普及,重点关注农村、女性及低文化水平的高危人群。     

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.     

患者健康问卷躯体症状群量表在综合医院的筛检价值

目的:探讨患者健康问卷躯体症状群量表(PHQ-15)中文版在综合医院门诊的筛检价值。方法:600名综合医院普通门诊患者在规定指导语下完成PHQ-15中文版、广泛性焦虑量表(GAD-7)、抑郁症状群量表(PHQ-9)自评量表,并接受经过培训的精神科专业人员进行汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)的评定。随机抽取其中44名患者在完成初次评定后7~14 d内接受PHQ-15重测。以HAMA、HAMD、GAD-7、PHQ-9为效标,分别与PHQ-15进行相关分析。计算躯体症状群检出率,并分析其人口学特征。分析PHQ-15不同分数段与焦虑、抑郁症状群的关系。结果:PHQ-15内部一致性信度系数为0.73,重测信度系数为0.75。PHQ-15得分与HAMA、HAMD、GAD-7、PHQ-9得分均呈正相关(r=0.65、0.68、0.52、0.73,均P<0.05)。探索性因素分析得到全身不适、胃肠不适和心胸不适3个公因子。检出躯体症状群者共364人,占总样本量的60.7%。不同性别、年龄、就业情况和就诊科室患者的躯体症状群检出率差异均有统计学意义。女性检出率高于男性(64.5%vs.56.0%);45~59岁者检出率高于其他年龄段(71.3%vs.53.4%、53.2%、60.2%);非在职者检出率高于在职者(64.2%vs.54.9%);内科就诊者检出率高于外科及其他科室就诊者(64.5%vs.47.4%),均P<0.05。PHQ-15得分≥15分者合并抑郁(93.1%vs.0、2.5%、46.7%)、焦虑(34.5%vs.0.4%、2.5%、12.0%)、抑郁合并焦虑症状群检出率(31.0%vs.0、0.4%、4.3%)均高于其他分值者(均P<0.001)。结论:患者健康问卷躯体症状群量表中文版可用于筛查躯体症状为表现的精神问题和躯体症状严重程度的评估,具有较好的信效度。     

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。     

昆明市情感障碍流行病学调查

目的:了解昆明市情感障碍患病率。方法:采用分层容量比例概率随机抽样法,应用中文版复合性国际诊断交谈检查2.1版(CIDI-2.1)对该市≥15岁的居民5033人进行访谈,调查情感障碍的患病率,分析影响情感障碍的相关因素、起病年龄及共病情况。结果:情感障碍30天患病率为0.98%,12个月患病率为1.22%,终生患病率为1.89%,单因素分析结果显示,城镇居民、离婚/分居/丧偶人群、无业者、受教育程度较高者更易患抑郁症。多因素分析结果显示,家居农村、男性可能是情感障碍的保护因素。不同情感障碍亚型起病年龄不同,90%的双相情感障碍患者在25岁以前起病,情感恶劣在50岁以前存在起病风险,重性抑郁的起病风险持续终生。患有焦虑障碍和疼痛障碍可以增高情感障碍的患病风险。结论:情感障碍患病率低于国外同类研究而与国内研究接近,城镇居民、女性、独身、无业,受教育程度较高者有较高的患病风险,是干预的重点人群。     

湖南省浏阳市农村居民抑郁症患病率调查

目的:了解农村居民抑郁症的患病率及分布特征.方法:采用分层多级随机抽样方法抽取浏阳市≥15岁农村居民7347人,以SCID为筛查和诊断工具.诊断标准为DSM-IV.结果:抑郁症总患病率为4.0%f95%CI:3.6%～4.4%),其中目前重症抑郁发作为1.9%(95%CI:1.6%～2.2%),既往重症抑郁发作为1.3%(95%CI:1.0%～1.6%),心境恶劣障碍为0.8%(95%CI:0.6%～1.0%).女性抑郁症患病率(4.6%)高于男性(3.3%)(χ2=8.928,P=0.030),对年龄进行标化后男女患病率的差异仍有统计学意义(χ2=6.129,P=0.013).不同年龄组患病率的差别有统计学意义(χ2=50.986,P=0.000),以40岁～70岁中老年人群患病率较高.结论:浏阳市农村居民抑郁症患病率水平较高,人群分布以女性和中老年人患病率最高.     

女性更年期抑郁症相关因素分析

目的了解女性更年期抑郁症患病率及其相关因素。方法在全国22省(市)分层抽样调查2400名45~55岁妇女,使用抑郁自评量表进行评估。结果女性更年期抑郁患病率高达23.80%,患有慢性病、工作压力大、体力劳动者、离婚、丧偶、与子女关系差、邻里关系差、经济收入低、睡眠差的女性更年期抑郁症状患病率较高,差异显著,有统计学意义(P<0.05或P<0.01)。结论女性更年期抑郁症的发生与躯体、心理和社会因素多种因素有关。     

抑郁症患者的家庭暴力及因素分析

目的:研究家庭暴力与抑郁症个性特点、社会支持、应对方式的关系,针对心理十预提供理论依据。方法:采用自行设计的家庭暴力调查表、汉密尔顿抑郁量表(HAMD)、社会支持评定量表、特质应对方式问卷和艾森克人格问卷(EPQ),对72例抑郁症患者进行评定和比较。结果:有家庭内暴力者38例(男16例,女22例),家庭暴力与抑郁症患者HAMD 抑郁总分呈正相关;有家庭暴力组男性的主观支持分、总社会支持分低于无家庭暴力组(18.8±4.9,22.6±3.4;33.7±8.2,39.6±6.4,P<0.05),消极应对分高于无家庭暴力组(34.9±4.7,30.1±6.5,P<0.05);有家庭暴力组女性的支持利用度分低于无家庭暴力组(6.1±2.0,8.1±2.0,P<0.05), EPQ的神经质评分高于无家庭暴力组(64.2±7.4,56.5±10.3,P<0.05)。结论:抑郁症患者的家庭暴力事件应予以重视,家庭暴力与男性抑郁症患者的绝望感、主观支持、总社会支持及消极应对方式相关;家庭暴力与女性的支持利用度和神经质个性相关。     

Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health Surveys

BACKGROUND: Prior research on the association between affective disorders and physical conditions has been carried out in developed countries, usually in clinical populations, on a limited range of mental disorders and physical conditions, and has seldom taken into account the comorbidity between depressive and anxiety disorders. METHODS: Eighteen general population surveys were carried out among adults in 17 countries as part of the World Mental Health Surveys initiative (N=42, 249). DSM-IV depressive and anxiety disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions were ascertained via a standard checklist. The relationship between mental disorders and physical conditions was assessed by considering depressive and anxiety disorders independently (depression without anxiety; anxiety without depression) and conjointly (depression plus anxiety). RESULTS: All physical conditions were significantly associated with depressive and/or anxiety disorders but there was variation in the strength of association (ORs 1.2-4.5). Non-comorbid depressive and anxiety disorders were associated in equal degree with physical conditions. Comorbid depressive-anxiety disorder was more strongly associated with several physical conditions than were single mental disorders. LIMITATIONS: Physical conditions were ascertained via self report, though for a number of conditions this was self-report of diagnosis by a physician. CONCLUSIONS: Given the prevalence and clinical consequences of the co-occurrence of mental and physical disorders, attention to their comorbidity should remain a clinical and research priority.     

农村女性自杀未遂者的相关因素研究

目的：研究农村女性自杀未遂者自杀行为的相关因素,方法：应用自编的自杀未遂者自杀原因与方式调查表,家庭环境量表,心理健康测查表,对128名自杀未遂者进行测查,评定,并进行1：1的对照研究。结果：自杀未遂者的自杀原因主要为婚恋家庭矛盾（43．8％）,邻里关系矛盾（25．8％）;自杀方式主要为服毒服药（49．2％）,自溺（25．8％）、自缢（16．4％）,研究组与对照组在家庭亲密度、文化性、娱乐性,组织性的不满意程度上及家庭矛盾性方面有显著性差异（P＜0．01）。自杀未遂者具有焦虑、疑心、抑郁、脱离现实等人格特征。自杀组中22例能出精神病学诊断,结论：农村女性产生自杀未遂行为与其人格特征,不良家庭环境及精神障碍有关,应积极进行干预。     

Psychiatric sequelae following breast cancer chemotherapy: a pilot study using claims data

Despite attention to depression and cognitive disorders, the prevalence of other mental disorders following breast cancer chemotherapy has not been well described. The authors undertook a pilot study using insurance claims data to compare the prevalence of mental disorders other than depression in a population of breast cancer surgery patients who did versus did not receive postsurgical chemotherapy treatment. Women receiving chemotherapy in addition to surgery were more likely to be diagnosed with adjustment disorders (odds ratio=2.01, 95% CI=1.04-3.87). Prevalence of depression, anxiety, cognitive, and sleep disorders were not dependent on receipt of post-surgical chemotherapy treatment. These findings support the need for heightened awareness for mental conditions following chemotherapy.     

有主观抑郁症状的孕产妇精神障碍的发生率

目的 分析有主观抑郁症状的孕产妇精神障碍的发生率状况.方法 2020年3月1日至2021年2月28日,对在某三甲医院建档的孕妇和产妇分别使用9项患者健康问卷和爱丁堡产后抑郁量表进行心理筛查.对PHQ-9≥5分的孕妇、EPDS≥9分的产妇进行随访,使用简明国际精神神经访谈确认其精神障碍的发生状况.结果 随访342名女性中...     

Personality traits and the reporting of affective disorder symptoms in depressed patients

BACKGROUND: A deeper understanding of the influences on self-reported mood symptoms could inform the debate about the utility of self-report instruments and enhance the assessment and treatment of affective disorders. We tested the hypotheses that higher Neuroticism is associated with the over-reporting of affective symptoms and lower Openness to Experience is associated with the under-reporting of affective symptoms. METHODS: Subjects were 134 inpatients of ages 50 and over diagnosed with a mood disorder. Personality was assessed with the Revised NEO Personality Inventory. Self-reported depression was assessed with the Beck Depression Inventory-II; observer-rated depression was assessed via the Hamilton Depression Rating Scale. Symptom-reporting was defined as the ratio of self-reported to observer-rated symptoms. RESULTS: As hypothesized, multivariate linear regression analyses revealed that high Neuroticism contributed to patients' over-reporting of mood symptoms. Contrary to the hypothesis, low Openness was associated with high ratios of self-reported to observer-rated mood symptoms. LIMITATIONS: Cross-sectional design and unclear generalizability to racial/ethnic minorities. CONCLUSIONS: Traits are important correlaters of self-reported vs. observer-rated symptoms in patients with affective disorders. To the extent that economic imperatives and other pressures impel greater reliance on self-report data in mental health research and services, there will be a corresponding need for prospective research on the determinants and clinical implications of discrepancies between self-reports and observer ratings.     

妇科门诊患者的精神障碍患病率调查

目的：调查综合医院妇科门诊精神障碍的患病率情况。方法：在一所综合医院的妇科门诊连续收集1626名就诊者，应用《问题导向的患者报告》进行筛查。按筛查阳性阴性各半收集其中198名就诊者，由两名精神科医师采用《简明国际神经精神检查》进行精神状况检查，并根据标准DSM-IV做出精神科诊断。结果：妇科门诊就诊患者精神障碍患病率为38％，符合两种精神障碍者为6％。各精神疾病障碍中的患病率较高的为：广泛性焦虑障碍7．38％，抑郁障碍8．76％，躯体化障碍8．40％，心境恶劣7．64％。依据DSM-IV附录条目发现的经前情绪障碍为2．85％，自杀问题（包括自杀意念或自杀未遂）5．71％。结论：妇科门诊患者的精神障碍患病率高，并且以抑郁、焦虑、躯体化等障碍和自杀问题多见。     

Psychosocial factors associated with suicidal ideation in clinical patients with depression

Background

Depression is a major risk factor for suicide, but few studies have examined psychosocial risk factors for suicide in clinical patients with depression. The purpose of this study was to investigate psychosocial factors which could be associated with suicidal ideation in clinical patients with depression including: sick-leave, help-seeking behavior, and reluctance to admit mental health problems.

Methods

A multi-center cross-sectional survey using self-report questionnaire was conducted at 54 outpatient psychiatric clinics in Tokyo in 2012. Adult outpatients who were diagnosed by psychiatrists as mood disorders (F30–F39) in the International Classification of Diseases-10 (ICD-10) were included in the study. Those who met the criteria for current hypomanic or manic episode were excluded from the study.

Results

A total of 189 patients with depression participated in the survey. Multivariable logistic regression analysis showed that taking sick-leave and having sought help from family were associated with decreased odds of current suicidal ideation. Moderate or more severe depression was associated with increased odds of suicidal ideation, and reluctance to admit own mental health problem tended to increase odds of suicidal ideation.

Limitations

Living status and suicidal ideation before consultation with psychiatrist were not investigated. Severity of suicidal ideation and comorbid psychiatric disorders were not assessed.

Conclusions

Importance of treatment of more severe depression for suicide prevention was confirmed. Industrial health staffs should consider the possibility of positive effect of taking sick-leave when they see employees with depression. Promoting help-seeking for family and reducing stigma of mental illness may be effective for suicide prevention.     

Screening and pathways to maternal mental health care in a South African antenatal setting

In low-resource settings, a stepped care approach is necessary to screen and provide care for pregnant women with mental health problems. This study sought to identify screening items that were most robust at differentiating women experiencing psychological distress and requiring counselling [assessed by screening with the Edinburgh Postnatal Depression Scale (EPDS) and a Risk Factor Assessment (RFA)] from those with a psychiatric disorder as diagnosed by a psychiatrist. Case records of women in an antenatal mental health service in Cape Town were reviewed. Composite scores and individual items on screening scales (EPDS, RFA) of participants who qualified for counselling (n?=?308) were compared to those of participants who were diagnosed with a psychiatric disorder (n?=?58). All participants with a psychiatric disorder were diagnosed with either depression or anxiety disorders. These participants had higher mean scores on the EPDS and RFA than those who qualified for counselling (p?<?0.01). Logistic regression and ROC analyses suggested that the best items to distinguish women with depression or anxiety from those qualifying for counselling were ‘I have felt sad and miserable’, ‘I am not pleased about being pregnant’ and ‘I have had serious depression, panic attacks or problems with anxiety before’ (sensitivity 0.655, specificity 0.750 for this combination of three items). A small number of items may be useful in screening for mental illness in pregnancy which requires higher levels of care. Such screening may contribute to a more efficient stepped care approach.     

Anxiety disorders in a public mental health system: clinical characteristics and service use patterns

BACKGROUND: Anxiety disorders are among the most common forms of psychiatric disorder, yet few investigations have examined the prevalence or service use of clients with anxiety disorders in the public mental health sector. METHODS: We examined demographics, clinical information, and service use in clients with anxiety disorders enrolled in San Diego County Adult and Older Adult Mental Health Services in fiscal 2002-2003. RESULTS: Almost 15% of the sample had a diagnosis of an anxiety disorder based on administrative billing data. Most anxiety disorder clients had additional psychiatric diagnoses, most commonly depression. Clients with both anxiety disorders and depression were more likely than those with anxiety or depression alone to use emergency psychiatric services and outpatient services than those with depression alone. Those with anxiety disorders alone used more outpatient services than those with depression alone. LIMITATION: Data were taken from an administrative database. CONCLUSIONS: Data indicate that anxiety disorders are not uncommon in public mental health settings and are associated with higher utilization of outpatient mental health services.     

Can gender differences in the prevalence of mental disorders be explained by sociodemographic factors?

Summary Background and aims: Epidemiological studies throughout the world consistently reported higher rates of depression and anxiety disorders in women, whereas men consistently show higher rates of substance and antisocial disorders. The present study examined factors potentially contributing to these gender differences using general population data.Methods: The sample was drawn from population registries (N=4181) and can be regarded as representative for the adult German population aged 18–65. Mental disorders (DSM-IV) were assessed with a diagnostic interview (CIDI) carried out by clinically trained interviewers. A range of sociodemographic variables was analysed within men, within women, and between genders.Results: The prevalence of common mental disorders (mood, anxiety, substance use and somatoform disorders) is higher among females, with the exception of substance use disorders. Young age was related to substance disorders both in women and in men. Not being married and being unemployed were associated with increased rates of mental disorders in both sexes, but in men stronger than in women. Being retired was associated with depression only in women, whereas belonging to a higher social class, working fulltime and having children appeared to be protective factors for men only. Other sociodemographic factors (concerning education, employment and family status) were not associated with increased rates of mental disorders both in women and men.Conclusion: Overall the emotional advantages or disadvantages of marital status, employment status, number of children, parenthood and social class apply equally to men and women. We cannot explain the female preponderance in most mental disorders by detecting specific unfavourable patterns of sociodemographic correlates, suggesting that determinants of gender differences in common mental disorders are still far from being understood.