四川省残疾人受教育程度分析

目的：分析四川省残疾人受教育情况。方法：根据第2次全国残疾人抽样调查方案,采取分层、多阶段、整群、概率比例抽样调查38个县市,152个乡镇/街道,304个小区,40351户人家,总人口125641人,男62735人,占49.93%;女62906人,占50.07%;城市38125人,占30.34%;农村87 516人,占69.66%。结果：抽查的6岁及以上人群中,大部分为小学文化程度和初中文化程度,分别占人口比例40.5%和27.3%;6岁及以上残疾人中,大部分为不识字及小学,分别占人口比例49.5%和33.3%;所调查的残疾人中,有88人中专文化程度,有40人获得了大学专科学历,16人获得大学本科学历。在调查的残疾人中,多重残疾人及智力残疾人受教育程度更差,不识字所占比例更大,分别为70%和62.4%;其次为视力残疾人及听力残疾人,分别为54.8%和48%。结论：四川省残疾人受教育程度不容乐观,大部分为不识字及小学;在调查的残疾人中,多重残疾人及智力残疾人受教育程度更差,其次为视力残疾人及听力残疾人,表明智力残疾,视力残疾及听力残疾对残疾人接受教育影响更大。     

浙江省精神病专科医院住院患者疾病谱调查

目的调查2010年浙江省精神病专科医院住院患者的疾病构成情况,为我省精神病防治提供理论依据。方法从我省42家精神专科医院采用两阶段分层随机抽样方法,抽出14家精神病院．再从14家医院中抽出3个月（3、7、11月）的出院患者进行调查。编制《住院患者住院情况调查表》收集患者住院诊断、性别、年龄、合并症及医院感染情况。结果调查住院患者共7684例,男3102例（4037％）,女4582（59．63％）例;年龄10～92（43．4±16．8）岁;住院患者疾病构成前5位的分别为精神分裂症和其他精神病性障碍（40．6％）,心境障碍（34．6％）,癔症、应激相关障碍、神经症（14．1％）,器质性精神病（5．6％）和精神活性物质或非成瘾物质所致精神障碍（1．98％）。次要诊断主要有高血压、白细胞减少症和糖尿病。医院感染主要有上呼吸道感染（26．1％）,胃肠道感染（24．4％）,肺部感染（22．4％）等。结论我省精神病防治仍应以精神病性障碍、心境障碍和神经症及器质性精神障碍的防治为主。躯体疾病在精神科临床工作中值得重视,精神疾病单病种管理需要考虑躯体疾病的影响。     

全国0～6岁儿童视力残疾抽样调查

目的 探讨我国儿童视力残疾的现状。方法采用随机抽样的方法,2001年对全国0～6岁儿童进行低视力和盲的抽样调查。在全国抽取6个省(市)0～6岁儿童共6024人,由专业医生检查视力,筛查并进行诊断。结果在抽查儿童中,视力残疾64人,总患病率1．1％,其中盲童20人,患病率0．33‰,低视力44人,患病率0.73‰。视力残疾主要原因为弱视21例,占32．80%,其次是视网膜和视神经病变10例,占15．6％,先天性白内障9例,占14．1％。结论我国0～6岁儿童视力残疾总患病率1．1‰,其中盲的患病率接近世界发达国家水平。视力残疾以低视力占多数,致病原因中,弱视为首位,而弱视、白内障等大多可以通过早期治疗脱残。     

The treatment of newborn infants with major handicaps. A survey of obstetricians and paediatricians in Victoria

We report the results of a survey of the attitudes and practices of obstetricians and paediatricians in Victoria with respect to the treatment of infants born with severe handicaps. Eighty-seven obstetricians and 111 paediatricians either completed questionnaires or agreed to be interviewed during the period 1981-1982. The treatment of severely handicapped infants is a matter of increasing concern to members both of the public and of the medical profession. The principal question is whether every infant should have its life prolonged by all available means, or whether some infants born with severe handicaps should be allowed to die. We attempt to identify areas of consensus and disagreement. We do not propound any particular point of view--our intention is rather to stimulate debate.     

凉山州彝族外出民工患精神障碍的调查分析

目的:探讨凉山州彝族外出务工人员的精神障碍患病率高的原因及可能解释。方法:对914例外出彝族务工者进行问卷性调查,并在初筛后使用PANSS及SDS、SAS量表进行评定。结果:914例中,取样895例,并发现精神障碍患病率为19.8%,有178例出现各样精神问题,其与山东、青岛、甘肃天水的调查报告中除酒精问题的精神障碍的患病率高(P<0.05),与青海的相比差异更为明显(P<0.001)。结论:凉山地区由于历史,宗教信仰,民族生活习惯,语言交流,文化程度等因素,致凉山彝族外出务工者患精神障碍较高。     

西藏自治区四类常见神经精神障碍的流行病学调查

目的了解神经症、酒使用障碍、精神发育迟滞和癫痫这4类常见的神经精神障碍在西藏的流行情况,为政府制订卫生规划提供科学依据。方法抽样参考两次全国精神障碍流行病学调查方法,在西藏具有代表性的4个地市进行,采取分级配额随机整群抽样方法,以常住人口为调查对象。筛查工具分别使用神经症筛查表、酒依赖及相关问题筛查表、儿童智力筛查表和癫痫筛查问卷;面检采用SCID-Ⅰ(美国精神障碍诊断与统计手册轴Ⅰ障碍用临床定式检查执行手册/研究版)作为定式检查工具。焦虑障碍和酒使用障碍以DSM-Ⅳ(美国精神障碍诊断与统计手册-第4版)为诊断标准,精神发育迟滞和癔症参考ICD-10(国际疾病分类,第10版)和CCMD-3(中国精神障碍分类与诊断标准,第3版)的诊断标准,癫痫按国际流调标准进行诊断。结果神经症、酒使用障碍、精神发育迟滞和癫痫的时点患病率分别为2.56%、4.06%、0.28%和0.68%;终生患病率分别为2.62%、4.24%、0.28%和0.72%。结论酒使用障碍和神经症是西藏两类最常见的精神健康问题;精神发育迟滞与癫痫则是危害西藏儿童和青少年身心发育的两类重大神经精神障碍,这些疾病的防治应列为本地区卫生工作规划中的重点。     

酒精所致精神障碍292例临床分析

目的:探讨普洱地区酒精所致精神障碍的临床特征与相关因素。方法:对2009年~2010年入院的292例酒精所致精神障碍住院患者的临床资料进行回顾性分析。结果:住院者以汉族、彝族、哈尼族为主,男性、文化程度低、从事重体力劳动者、有阳性家族史、经济条件差者本病发病率较高,性格外向型者较多,精神症状幻视、幻听、被害妄想、行为紊乱较多见,神经系统症状以震颤、共济失调较多见,并伴发多种躯体疾病,采取综合治疗措施疗效好,转归快,但再住院率高。结论:普洱地区酒精所致精神障碍住院者多、症状表现多样,采取综合性治疗干预效果满意’但复发问题不容忽视。     

湖南省严重精神障碍患者在国家重性精神障碍管理治疗项目中的诊断可靠性研究

目的　了解湖南省15岁及以上严重精神障碍患者在国家重性精神障碍管理治疗项目中的诊断可靠性。方法　于2015年2—6月,采用多阶段、分层、整群抽样的方法,针对湖南省14个市包括123个县区72 999名15岁及以上社区常住人群开展严重精神障碍患者流行病学调查,以现场流行病学调查发现的720例严重精神障碍患者的诊断结果为金标准,评价国家重性精神障碍管理治疗项目中湖南省患者诊断结果的一致性。结果　720例患者中目前已纳入国家重性精神障碍管理治疗项目中的有349例（48.5%）,其中345例患者在项目中被确诊为严重精神障碍,严重精神障碍患者识别率为47.9%（345/720）。国家重性精神障碍管理治疗项目中的严重精神障碍诊断符合率为39.4%（284/720）,其中精神分裂症、偏执性精神障碍、双相情感障碍、分裂情感性精神障碍、癫痫所致精神障碍、严重精神发育迟滞的诊断符合率分别为50.6%（273/539）、0、2.7%（2/75）、12.5%（1/8）、16.7%（4/24）、6.2%（4/64）。湖南省各地区严重精神障碍的诊断符合率比较,差异无统计学意义（χ2=16.83,P=0.21）。结论　湖南省严重精神障碍患者管理率和诊断符合率有待提高,不同地区诊断符合率差别不高。国家重性精神障碍管理治疗项目除提高社区患者的管理率外,诊断可靠性也亟待提高。     

西安市社区老年人心理健康状况及其影响因素分析

目的 分析西安市社区老年人心理健康状况及其影响因素,提出保障老年人心理健康的对策和建议.方法 采用便利抽样的方法抽取西安市两个社区310名60岁及以上老年人,使用自制调查问卷进行入户调查.调查内容包括社会人口学特征、社会支持、体育锻炼、失能情况、慢性病消费、心理疾病及其应对方式等.利用SAS 9.1.2软件的单因素x2检验和多因素logistic回归模型分析老年人心理健康的影响因素.结果 剔除回答不完整或怀疑不真实的问卷,获得有效问卷304份,有效率为98.1％.被调查人群的心理疾病检出率为27.1％.单因素x2检验结果显示慢性病医疗消费、失能情况、社会支持和体育锻炼是影响因素,多因素logistic回归分析结果显示医疗保险、慢性病医疗消费、社会支持和体育锻炼是影响因素.结论 在老龄化和家庭养老功能日益弱化的形势下,必须重视精神养老问题,通过提高老年人的社会保障水平,完善和构建社区精神养老服务等外部支持系统,有效提升老年人的心理健康水平.     

Respite care on a children's ward

In March 1984 a short term respite care facility for handicapped children was opened in a children's ward catering primarily for acute medical and surgical problems. The facility was based on a four bedded room designed so that if beds became short in the main ward it could revert immediately to the care of acutely sick children. Three nurses were appointed specifically to staff the facility, the nursing budget for the rest of the ward being reduced proportionately. Conversions were funded by charities and some of the conversion work done by volunteers. The main users were totally dependent children aged under 5 with severe mental and physical handicaps. Parents found the service invaluable, and in addition to planned admissions it was usually possible to accept a child at short notice--for example, when some domestic crisis occurred. Only very rarely was admission impossible because of the needs of acutely ill children. A short term respite care facility not only helps parents cope and may provide beneficial experience for a handicapped child but is also a useful training ground for medical students and junior staff.     

Current status of soil-transmitted nematode infection in China

Objective To carry out national surveys for ascertaining the current status and trends of soil-transmitted nematode infections in China, providing scientific basis for further developing control strategies. Methods In 1988-1992 （hereinafter abbreriated as ＂survey in 1990＂）, a stratified cluster random sampling method was used in the survey. In 2001-2004 （hereinafter abbreriated as ＂survey in 2003＂）, in order to compare with the survey in 1990, two-characteristic stratified cluster random sampling method was used and 687 investigation spots were sampled from the 2848 spots selected in the survey in 1990. Kato-Katz thick smear method was used to examine the eggs of soil-transmitted nematodes in fecal samples. Results The prevalence rates were 53.6% and 19.6% for soil-transmitted nematodes, 14.6% and 6.120% for hookworms, 44.6% and 12.7% for Ascaris lumbricoides, 17.4% and 4.630% for Trichuris trichiura in survey 1990 and survey 2003, respectively. The prevalence rates of soil-transmitted nematodes were higher in 13 provinces than the average level in China in the survey in 1990, and higher in 8 provinces than the average level in the survey in 2003. The prevalence of hookworms, Ascaris lumbricoides, Trichuris trichiura and the overall prevalence of soil-transmitted nematodes were higher in females than in males. It is estimated from the results of survey in 2003 that the number of persons with soil-transmitted nematode infections in the country is about 129 million, less than that in the survey in 1990. Conclusion The prevalence of soil-transmitted nematodes has declined considerably but is still relatively high in some provinces and autonomous regions. Control activities and socioeconomic development may have contributed to the decreased prevalence.     

方山县初中生结核菌感染和患病情况调查

目的：调查中学生的结核菌感染和患病情况，为制定方山县预防和控制本病的发生与流行规划提供特定人群的依据。方法：采用结核菌素试验方法对方山县境内三所中学6148名初中生的结核菌感染和患病情况进行调查。结果：结核菌感染阳性率平均为84．94％，明显高于1991年WHO调查结果；活动性肺结核患病率146．4／10万，高于2000年结核病流调全国水平122／10万，而略低于山西省149／19万水平。结论：提示方山县近二年来实施现代结核病控制策略(DOTS)，启动日援项目及全球基金项目进行治疗，使结核病流行情况明显改善的同时仍应重视在校初中生的结核病防治工作。     

Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study

The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.     

惠州市杨侨镇精神障碍流行病学调查

目的：了解惠州市杨侨镇精神障碍的患病率及分布特点。方法：2010年8月20日至9月20日整群抽样杨侨镇5个办事处400户（其中200户为越南归国华侨,200户为非华侨）为调查对象。由具有5年以上精神科临床经验的医生采用1982年精神疾病流行病学调查协作组编写的《精神疾病流行病学调查手册》进行逐户筛选,以CCMD-3对可疑精神障碍者进行诊断与分类。结果：1420人完成筛选,83人完成诊断,精神障碍时点患病率57．75％o,终生患病率58．45‰,15岁以上人口时点患病率为65．92‰,终生患病率为66．72‰。精神分裂症男性患病率是女性的3．67倍（P〈0．05）,≥55岁以上人群的器质性精神障碍是所有人群的10倍,排在前三位的是精神分裂症、酒精依赖、抑郁症。结论：与1982年全国流调数据相比,精神疾病的患病率呈升高趋势,各类精神障碍有其相应的年龄分布特点。     

Reproductive Tract Infections——A Main Factor Influencing Women＇s Mental Status： Comparison on Depression and Anxiety between Naxi Women with and without RTIs

Objectives 1） To explore the relationship between RTIs and mental status of Naxi women; 2） to compare the differences of depression ＆ anxiety between Naxi women who have and not have RTIs; and 3） to put forward some suggestions for improving Naxi women＇s reproductive health in psychological point of view. Methods A cross-sectional survey was adopted, 280 married Naxi female volunteers who aged above 20 years old were selected by cluster random sampling from the two selected villages of Lugufu Township of Yanyuan county in Sichuan. Two self-reporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results The facts of mental status of Sichuan Naxi women brook no optimism. Among 280 Naxi reproductive age women who were investigated in current study, only 74 （26.4%） have no depression symptoms, and 116 （41.4%） have no anxiety symptoms. For the study population, the average total scores （TS） of CES-D was 20.1, and the average total index scores （TIS） of SAS was 50.2, and both of them were above a minimum value doubted to have symptoms. There were big differences of both average TS of CES-D and TIS of SAS between Naxi women who have and not have RTIs. Further analysis revealed that RTI was a main risk factor influencing women＇s mental status （OR = 16. 043 for depression, and OR = 12.954 for anxiety）. In addition, Naxi women＇s depression and anxiety were related to order births （≤2, OR=3.149, 95% CI： 1.228, 8.076）, sex debut was younger （≤17, OR=3.043, 95% CI： 1.895, 4.884）, and multiple pregnancy （≥ 3, OR=2.728, 95% CI： 1.990, 4.173）, etc. Conclusion For improving Naxi women＇s mental status, a pressing matter of the moment is for local medical persons to gain the knowledge about mental health and the diagnosis and treatment levels of psychological disorders. At the same time, pssychological counselling should become a main activity of reproductive health services.     

傈僳族乙型肝炎病毒感染的流行病学调查

采取分层整群抽样法,在四川省德昌县傈僳族聚居地及其毗邻汉族聚居地作乙型肝炎流行病学调查。共调查傈僳族198户,1062人;汉族210户,753人;采血傈僳族745人,汉族574人。发现傈僳族HBsAg阳性率为9.80％,抗-HBs阳性率9.66％,抗-HBc阳性率48.72％。乙肝血清流行率为51.41％。HBeAg阳性率为28。77％,抗-HBe阳性率36.99％。HBsAg亚型测定均属adr亚型。乙肝现患阳性率1.51％。本调查提示傈僳族HBsAg携带率、乙型肝炎血清流行率和全国各地相近,傈僳族和毗邻汉族之间无显著差异。     

Smoking and mental illness: A population-based prevalence study

CONTEXT: Studies of selected groups of persons with mental illness, such as those who are institutionalized or seen in mental health clinics, have reported rates of smoking to be higher than in persons without mental illness. However, recent population-based, nationally representative data are lacking. OBJECTIVE: To assess rates of smoking and tobacco cessation in adults, with and without mental illness. DESIGN, SETTING, AND PARTICIPANTS: Analysis of data on 4411 respondents aged 15 to 54 years from the National Comorbidity Survey, a nationally representative multistage probability survey conducted from 1991 to 1992. MAIN OUTCOME MEASURES: Rates of smoking and tobacco cessation according to the number and type of psychiatric diagnoses, assessed by a modified version of the Composite International Diagnostic Interview. RESULTS: Current smoking rates for respondents with no mental illness, lifetime mental illness, and past-month mental illness were 22.5%, 34.8%, and 41.0%, respectively. Lifetime smoking rates were 39.1%, 55.3%, and 59.0%, respectively (P<.001 for all comparisons). Smokers with any history of mental illness had a self-reported quit rate of 37.1% (P =.04), and smokers with past-month mental illness had a self-reported quit rate of 30. 5% (P<.001) compared with smokers without mental illness (42.5%). Odds ratios for current and lifetime smoking in respondents with mental illness in the past month vs respondents without mental illness, adjusted for age, sex, and region of the country, were 2.7 (95% confidence interval [CI], 2.3-3.1) and 2.7 (95% CI, 2.4-3.2), respectively. Persons with a mental disorder in the past month consumed approximately 44.3% of cigarettes smoked by this nationally representative sample. CONCLUSIONS: Persons with mental illness are about twice as likely to smoke as other persons but have substantial quit rates. JAMA. 2000;284:2606-2610.     

Changes in the prevalence of comorbidity of mental and physical disorders in Singapore between 2010 and 2016

INTRODUCTIONFew studies have examined the changes in the prevalence of comorbidity of mental and physical disorders in recent years. The present study sought to examine whether the prevalence of comorbidity of mental and physical disorders in Singapore showed any changes between 2010 and 2016.METHODSWe extracted data from two repeated nationally representative cross-sectional surveys conducted among resident adults aged ≥ 18 years in Singapore. Significant changes were tested using pooled multinomial logistic regression analyses.RESULTSThe prevalence of comorbid mental and physical disorders increased significantly from 5.8% in 2010 to 6.7% in 2016. Among those with physical disorders, there were significant increases over time in the prevalence of comorbid generalised anxiety disorder (GAD) (0.1% vs. 0.4%) and obsessive-compulsive disorder (OCD) (1.4% vs. 3.9%) in diabetes mellitus, and alcohol dependence in cardiovascular disorders (0.1% vs. 1.3%). Among those with mental disorders, there were significant increases over time in the prevalence of comorbid diabetes mellitus in OCD (4.1% vs. 10.9%), cancer in major depressive disorder (0.4% vs. 2.4%), and cardiovascular disorders in GAD (0.4% vs. 6.7%) and alcohol dependence (0.9% vs. 11.8%). Significant changes in the overall prevalence of comorbid mental and physical disorders were also observed across age group, education and employment status.CONCLUSIONThe prevalence of comorbid mental and physical disorders increased significantly over time. This finding supports the need for more appropriate clinical management with better integration between mental health and general medical care professionals across all aspects of the healthcare system to treat this comorbidity in Singapore.     

公众对精神病患者的社会歧视及其影响因素

目的 探讨公众对精神病患者的歧视状况及其影响因素.方法 本研究为描述性研究,采用问卷调查法,共调查l 378名公众;调查工具包括患者一般资料调查问卷和精神病患者遭受的社会歧视评估量表.结果 精神病患者遭受的社会歧视评估量表总分为（2.07±0.61）分,其中得分最高的是危险维度[（2.17±0.78）分],最低的是能力维度[（1.65±0.64）分];多元线性回归分析显示结果：影响精神病患者遭受的社会歧视评估量表总分的因素包括调查对象类别、年龄、性别、文化程度、与精神病患者的接触程度和生活联系程度.结论 由于精神病患者存在病耻感,且社会人口学因素、疾病因素、社会心理因素对此均有影响,因此护理人员应积极采用有效的干预措施,消除或降低患者的病耻感,促进精神病患者早日康复.