中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2010年
8期
933-937
,共5页
张天宏%肖泽萍%王兰兰%戴云飞%张海音%仇剑崟%陶明毅%王振%王虓%俞峻翰%吴艳茹%蒋文晖
張天宏%肖澤萍%王蘭蘭%戴雲飛%張海音%仇劍崟%陶明毅%王振%王虓%俞峻翰%吳豔茹%蔣文暉
장천굉%초택평%왕란란%대운비%장해음%구검음%도명의%왕진%왕효%유준한%오염여%장문휘
人格障碍%心境障碍%神经症性障碍%现况调查%门诊患者
人格障礙%心境障礙%神經癥性障礙%現況調查%門診患者
인격장애%심경장애%신경증성장애%현황조사%문진환자
Personality disorders%Mood disorders%Neurosis disorders%Cross-sectional survey%Outpatients
目的 调查上海市精神卫生专科医院门诊就诊者人格病理的分布及其相关因素.方法 采用系统抽样法,在上海市精神卫生中心设抽样点,对就诊于精神科门诊和心理咨询门诊的3075例就诊者进行随机抽查.以DSM-Ⅳ为诊断标准,以人格障碍诊断问卷(PDQ-4+)为人格障碍筛查工具进行初筛,对筛查阳性者应用轴Ⅱ人格障碍临床访谈(SCID-Ⅱ)进行临床诊断,采用logistic回归模型分析与人格障碍相关的危险因素.结果 在所有就诊者中,自评的人格障碍检出率为71.3%,经临床医生结构式访谈后确认符合人格障碍诊断标准的共计982例(31.9%).低年龄群体(OR=1.8,95%CI:1.5～2.1)、未婚或离异者(OR=1.6,95%CI:1.4～1.9)、心理咨询门诊患者(OR=1.2,95%CI:1.1～1.3)、心境障碍和神经症性障碍患者(OR=1.7,95%CI:1.4～2.0)中符合人格障碍诊断标准的患者比例更高.logistic回归分析提示:年龄小、童年时并非由父母抚养以及病前性格内向是人格障碍的相关危险因素.结论 人格障碍在精神卫生服务的对象中并不少见,特别是在就诊于心理咨询的心境障碍、神经症性障碍患者中,提示需要对该群体的人格病理进行积极的识别和干预.
目的 調查上海市精神衛生專科醫院門診就診者人格病理的分佈及其相關因素.方法 採用繫統抽樣法,在上海市精神衛生中心設抽樣點,對就診于精神科門診和心理咨詢門診的3075例就診者進行隨機抽查.以DSM-Ⅳ為診斷標準,以人格障礙診斷問捲(PDQ-4+)為人格障礙篩查工具進行初篩,對篩查暘性者應用軸Ⅱ人格障礙臨床訪談(SCID-Ⅱ)進行臨床診斷,採用logistic迴歸模型分析與人格障礙相關的危險因素.結果 在所有就診者中,自評的人格障礙檢齣率為71.3%,經臨床醫生結構式訪談後確認符閤人格障礙診斷標準的共計982例(31.9%).低年齡群體(OR=1.8,95%CI:1.5～2.1)、未婚或離異者(OR=1.6,95%CI:1.4～1.9)、心理咨詢門診患者(OR=1.2,95%CI:1.1～1.3)、心境障礙和神經癥性障礙患者(OR=1.7,95%CI:1.4～2.0)中符閤人格障礙診斷標準的患者比例更高.logistic迴歸分析提示:年齡小、童年時併非由父母撫養以及病前性格內嚮是人格障礙的相關危險因素.結論 人格障礙在精神衛生服務的對象中併不少見,特彆是在就診于心理咨詢的心境障礙、神經癥性障礙患者中,提示需要對該群體的人格病理進行積極的識彆和榦預.
목적 조사상해시정신위생전과의원문진취진자인격병리적분포급기상관인소.방법 채용계통추양법,재상해시정신위생중심설추양점,대취진우정신과문진화심리자순문진적3075례취진자진행수궤추사.이DSM-Ⅳ위진단표준,이인격장애진단문권(PDQ-4+)위인격장애사사공구진행초사,대사사양성자응용축Ⅱ인격장애림상방담(SCID-Ⅱ)진행림상진단,채용logistic회귀모형분석여인격장애상관적위험인소.결과 재소유취진자중,자평적인격장애검출솔위71.3%,경림상의생결구식방담후학인부합인격장애진단표준적공계982례(31.9%).저년령군체(OR=1.8,95%CI:1.5～2.1)、미혼혹리이자(OR=1.6,95%CI:1.4～1.9)、심리자순문진환자(OR=1.2,95%CI:1.1～1.3)、심경장애화신경증성장애환자(OR=1.7,95%CI:1.4～2.0)중부합인격장애진단표준적환자비례경고.logistic회귀분석제시:년령소、동년시병비유부모무양이급병전성격내향시인격장애적상관위험인소.결론 인격장애재정신위생복무적대상중병불소견,특별시재취진우심리자순적심경장애、신경증성장애환자중,제시수요대해군체적인격병리진행적겁적식별화간예.
Objective To study the prevalence and risk factors for personality disorder (PD)outpatients attending in for psychiatric and psychological counseling in Shanghai. Methods 3075 subjects were sampled by systematic sampling method from outpatients in psycho-counseling clinics and psychiatric clinics in Shanghai Mental Health Center. Based on DSM- Ⅳ criteria, personality disorders were assessed by both questionnaires (personality diagnostic questionnaire, PDQ-4+) and interviews (structured clinical interview for DSM- Ⅳ Axis Ⅱ , SCID- Ⅱ ). Logistic regression analysis was performed to determine the significant independent contributor to PD. Results 71.3% of the outpatients were found having pathological personality by using questionnaire of self rating PD scale. 982 outpatients (31.9%) met criteria for at least one personality disorder by using structured clinical interview. Younger age (OR= 1.8, 95% CI: 1.5-2.1 ), single or divorced (OR = 1.6, 95%CI:1.4-1.9), psychological counseling outpatients (OR=1.2, 95%CI: 1.1-1.3), mood and outpatients with neurosis disorders (OR = 1.7, 95%CI: 1.4-2.0) were more frequently assigned as personality disorders. Data from logistic regression analysis showed that patients of tender age, not nurtured and raised by their parents, with introvert characters were related risk factors of PD. Conclusion High prevalence rate of PD was found in this sample of Chinese outpatients, especially in thosepsychological counseling outpatients with mood or neurosis disorders. More attention should be paid to the recognition and intervention of PD in outpatients with mental disorders.
