CAJ | 학술논문

目的:了解青岛市≥18岁人群各类精神障碍的现患率和分布特点,为制定全市精神卫生规划提供科学依据.方法:采用多阶段分层整群抽样方法随机抽取青岛市≥18岁居民4800人.首先由精神科护士用扩展的一般健康问卷(GHQ-12)进行筛查,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精神科检查.根据调查设计特征将计算出的患病率进行调整并推广至全市成年人口.结果:4776人完成调查.调整后精神障碍总的现患率(最近1个月)为21.96%(95% CI为19.21%～24.99%).最常见的特定精神障碍为广泛性焦虑障碍(5.41%)、酒精使用障碍(5.33%)、重性抑郁障碍(3.43%)和心境恶劣障碍(2.72%).女性总的现患率略低于男性(OR=1.2,95% CI为1.1～1.3),男性酒精使用障碍现患率高于女性(OR=131.2,95% CI为72.6～237.2).农村与城市居民在精神障碍总的现患率方面的差异无统计学意义(OR=1.1,95% CI为0.6～2.3).在有精神障碍的人群中,仅6.46%曾经因心理问题在医疗机构就诊,但36.97%精神障碍对其影响程度为中等到严重.结论:青岛市精神障碍的患病率较高,精神障碍已成为迫切需要解决的公共卫生问题,有必要在全市范围内开展和实施全面的精神卫生规划并定期评估其效果.
목적:료해청도시≥18세인군각류정신장애적현환솔화분포특점,위제정전시정신위생규화제공과학의거.방법:채용다계단분층정군추양방법수궤추취청도시≥18세거민4800인.수선유정신과호사용확전적일반건강문권(GHQ-12)진행사사,장조사대상분위정신장애고、중、저위험조;연후용미국정신장애진단여통계수책(DSM-Ⅳ)축Ⅰ장애정식림상검사환자판대불동비례적삼조인군진행정신과검사.근거조사설계특정장계산출적환병솔진행조정병추엄지전시성년인구.결과:4776인완성조사.조정후정신장애총적현환솔(최근1개월)위21.96%(95% CI위19.21%～24.99%).최상견적특정정신장애위엄범성초필장애(5.41%)、주정사용장애(5.33%)、중성억욱장애(3.43%)화심경악렬장애(2.72%).녀성총적현환솔략저우남성(OR=1.2,95% CI위1.1～1.3),남성주정사용장애현환솔고우녀성(OR=131.2,95% CI위72.6～237.2).농촌여성시거민재정신장애총적현환솔방면적차이무통계학의의(OR=1.1,95% CI위0.6～2.3).재유정신장애적인군중,부6.46%증경인심리문제재의료궤구취진,단36.97%정신장애대기영향정도위중등도엄중.결론:청도시정신장애적환병솔교고,정신장애이성위박절수요해결적공공위생문제,유필요재전시범위내개전화실시전면적정신위생규화병정기평고기효과.
Objective: To describe the current prevalence and distribution of all types of mental disorders among persons aged 18 years and older in Qingdao City and develop a municipal mental health plan based on the data. Methods: Stratified multistage cluster randomization was used to identify 4800 individuals ≥ 18 years of age in Qingdao City. Subjects were classified as high, moderate or low risk of having a mental disorder based on an expanded version of the General Health Questionnaire (GHQ-12) . Different proportions of the three groups were assessed with the Structured Clinical Interview for DSM-Ⅳ-TR (SCID-I/P) . Estimated prevalence and confidence intervals were adjusted for design effects, clustering and post-stratified to the total adult population of the city. Results: Totally 4776 subjects completed the survey. The adjusted overall current prevalence of mental disorders was 21.96% (95% CI: 19. 21% ～24.99%) . The most common specific disorders were generalized anxiety disorders (5.41%), alcohol use disorder (5. 33%), major depressive disorder (3.43%) and dysthymia (2.72%) . The prevalence of any mental disorder and of alcohol use disorder were significantly higher in men than women (OR = 1.18, 95% CI: 1.09 ～ 1.28 and 131.21, 72.57 ～ 237. 23, respectively) . There was no significant difference in the prevalence of any mental disorder between rural and urban areas (OR = 1.13, 0.56 ～ 2. 30) . Only 6.46% of those with a diagnosable mental disorder had ever received medical treatment for the condition , but 36.97% were moderately to severely affected by the disorder. Conclusion: The high prevalence of mental disorders seriously affects the social and economic development of Qingdao. To address this major public health problem it will be necessary to develop and regularly monitor the effectiveness of a comprehensive mental health plan.