青海省18岁及以上人群精神障碍流行病学调查

目的:了解青海省成年人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法抽取青海省≥18岁人群12001人,用扩展的一般健康问卷(GHQ-12)筛查,将调查对象分为精神障碍高、中、低危险组,然后用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的三组人群进行诊断检查。将计算出的患病率调整并推广至青海省370万成年人口。结果:11178人完成了调查。调整后精神障碍总的现患率(最近1个月)为18.04%,95%可信区间(95%CI)为15.99%～20.28%;患病率前三位的分别是酒精使用障碍(12.24%)、广泛性焦虑障碍(1.40%)和心境恶劣障碍(1.13%)。男性精神障碍总的现患率及酒精使用障碍的现患率均明显高于女性[(27.92%vs.7.47%,23.39%vs.0.30%;OR(95%CI)=4.80(3.81～6.05),OR(95%CI)=100.22(35.07～286.38)];农村与城市居民精神障碍总的患病率差异无统计学意义(18.33%vs.17.08%,OR=1.09,95%CI:0.76～1.56)。在有精神障碍的人群中,功能损害程度为中等到严重者占15.48%,但仅2.59%有精神障碍者曾经因心理问题在医疗机构就诊,仅0.94%曾在精神科就诊。结论:青海省酒精使用障碍是特别需要关注的公共卫生问题。

Epidemiological survey of mental disorders in persons aged 18 and older in Qinghai Province

Objective : To describe the prevalence and distribution of mental disorders among adults in Qinghai Province. Methods: Using multi-stage stratified cluster sampling, 12, 001 individuals ≥ 18 years were selected in Qinghai Province. The subjects were screened with the expanded version of General Health Questionnaire (GHQ-12) and classified as high, moderate or low risk of having a mental illness. Different proportions of the three groups were assessed with the Structured Clinical Interview for DSM-Ⅳ-TR (SCID-I/P) . The estimated prevalence was adjusted to be representative of the 3.7 million adults in Qinghai. Results: Totally 11, 178 individuals completed the screening. The 1-month overall prevalence of any mental disorder was 18.04% (95% CI: 15.99% ～ 20.28%) . The three most common diagnoses were alcohol abuse (12.24%), generalized anxiety disorder (1.40%), and dysthmia (1.13%) . The overall prevalence of current mental disorders was much higher in males than in females (27.92% vs. 7.47%, OR =4. 80, 95%CI: 3.81-6.05), primarily because of the much higher rate of alcohol use disorders in males (23.39% vs. 0.30%, OR = 100.22, 95% CI: 35.07～286.38) .There was no significant difference in rural and urban overall rates (18. 33% vs. 17.08% , OR = 1.09, 95% CI: 0.76 ～ 1.56) . Among persons with a mental disorder, 15.48% had moderate to severe disability due to the disorder, but only 2.59% had ever sought medical help for psychological problems and only 0.94% had ever seen a mental health professional Conclusion: Alcohol use disorders are important public health problems that need special attention in Qinghai.