【摘要】 目的:了解山东省≥18岁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,随机抽取山东省5个地级市的5个区和15个县的10个街道和30个乡镇,共计20个居委会和60个行政村,抽取≥18岁人群23987人,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,然后由精神科医生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高、中和低危人群进行调查,作出有无精神障碍及具体诊断。结果:完成调查22718人,调整后精神障碍总的现患率(最近1个月)为19.48%(95%CI:17.48%～21.64%)。各类精神障碍现患率由高到低依次为心境障碍(5.93%)、物质使用障碍(5.62%)、焦虑障碍(5.50%)、精神病性障碍(1.28%)。男性精神障碍总的现患率(22.78%)高于女性(16.17%)(OR=1.53)。城市居民精神障碍的现患率(18.88%)与农村(19.68%)之间的差异无统计学意义。最常见的精神障碍依次为酒精使用障碍(5.55%)、心境恶劣障碍(1.99%)、重性抑郁障碍(1.50%)和精神分裂症(1.12%)。有精神障碍者中仅10.53%曾因心理问题在医疗机构就诊,但仅7.69%曾在精神科就诊。结论:精神卫生问题,特别是酒精使用障碍、重性抑郁障碍、心境恶劣障碍和精神分裂症,已成为山东省突出的公共卫生问题。更多还原

【Abstract】 Objective:To determine the prevalence and distribution of mental disorders in adults 18 years of age and older in Shandong Province.Methods:Stratified multistage cluster randomization was used to identify 23987 individuals≥18 years of age from 20 urban neighborhoods(from 10 sub-districts in 5 urban districts)and 60 rural villages(from 30 rural townships in 15 counties)from 5 prefects of the Shandong Province.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)(as administered by psychiatric nurses)and then psychiatrists determined their diagnoses by administering the Structured Clinical Interview for DSM-IV(SCID)to different proportions of the high-,moderate-,and low-risk subjects.Results:Among the 22718 who completed the screening,the prevalence of any current mental disorder was 19.48%(95% CI:17.48%~21.64%).The prevalence rates of diagnostic groups of disorders were as follows:mood disorders(5.93%),substance use disorders(5.62%),anxiety disorders(5.50%),and psychotic disorders(1.28%).The prevalence of any mental disorder was higher in males than in females(22.78% vs.16.17%,OR=1.53).There was no significant difference in the prevalence of any mental disorder between urban and rural residents(18.88% vs.19.68%).The current prevalence rates of the most common specific disorders were as follows:5.55%(alcohol use disorder),1.99%(dysthymia),1.50%(major depressive disorder)and 1.12%(schizophrenia).Only 10.53% of persons with a mental disorder had ever received any type of medical treatment for psychological problems and only 7.69% had ever received treatment from a mental health professional.Conclusion:Mental health issues,particularly alcohol use disorders,major depression,dysthymia and schizophrenia,are already prominent public health problems in Shandong Province.更多还原