2010年北京市精神障碍患病率及社会人口学因素分析

摘要

目的 了解和掌握北京市户籍常住人口中各类精神障碍的患病率及人口学分布特征.方法 采用多阶段分层整群随机抽样方法,抽取年龄≥18岁、在辖区内居住时间≥6个月的北京市户籍居民19874人为调查对象,采用修订后的SCID-Ⅰ/P(2.0版)和MMSE进行一对一访谈.对MMSE筛查阳性者(受教育水平小学及以下,MMSE得分≤17分;初中及以上,MMSE得分≤23分),由高年资精神科主治及以上的医师进行访谈,根据SCID诊断标准做出痴呆和精神发育迟滞的诊断.结果 共16032人(80.7%)完成调查;按年龄和性别标化后,精神障碍终生患病率为120.8‰(1937/16032,115.8‰~125.9‰),排名前3位的为:重性抑郁障碍(527例,32.9‰)、酒精依赖性和滥用性障碍(311例,19.4‰)、未特定焦虑障碍(270例,16.8‰);时点患病率为75.3‰(1207/16032, 71.2‰~79.4‰),排名前3位的为:特殊恐怖症(187例,11.7‰)、未特定焦虑障碍(186例,11.6‰)、重性抑郁障碍(162例,10.1‰).精神障碍患病率在高龄(OR=1.014)、女性(OR=1.428)、无业(OR=1.096)、与家人(OR=1.686)或周围人关系不和睦(OR=1.901)、有吸烟(OR=1.129)或饮酒史(OR=1.262)者中较高,在城市居住(OR=0.840)、受教育水平高(OR=0.813)、已婚/再婚/同居(OR=0.689)、无精神障碍阳性家族史(OR=0.405)者中较低.结论 12%的北京市居民一生中至少罹患过1种精神障碍;高龄、女性、受教育程度低、居住在农村、精神障碍阳性家族史、社会支持系统不良与精神障碍的发生有关.%Objective To study the prevalence and socio-demographic correlates of mental disorders in Beijing residents. Methods The multi-stage stratified cluster random sampling method was used,19 874 residents aged 18 or above who had lived for more than six months in Beijing were selected. Face-to-face assessment was conducted by trained investigators by using the Chinese version of the Structured Clinical Interview for DSM-ⅣAxisⅠDisorders-Patient Edition(SCID-Ⅰ/P)to find any mental disorders, and the Mini-Mental State Examination (MMSE) to screen for dementia and mental retardation. Those who were positive on MMSE(MMSE≤17 for those who completed elementary education or less,≤23 for those who completed middle school or above) were further assessed to confirm dementia and mental retardation by using the SCID. Results 16 032 (80.7%) out of 19 874 eligible residents completed the face-to-face assessment. Adjusted by age and gender, the lifetime prevalence of all mental disorders was 120.8‰ (1 937/16 032, 115.8‰-125.9‰), and the top three most common ones were major depressive disorder (527,32.9‰), alcohol dependence and abuse (311, 19.4‰), and anxiety disorder, NOS (270, 16.8‰). The point prevalence of all mental disorders was 75.3‰ (1 207/16 032,71.2‰-79.4‰), the top three were specific phobias (187, 11.7‰),anxiety disorder, NOS (186, 11.6‰), and major depressive disorder (162, 10.1‰).The prevalence of mental disorders was significantly higher in the elderly(OR=1.014),female(OR=1.428),unemployed(OR=1.096),people having poor rapports with family(OR=1.686) or others(OR=1.901), smoking(OR=1.129)or drinking(OR=1.262). The prevalence of mental disorders was significantly lower in the urban residents(OR=0.840), people in a higher level of education(OR=0.813), people who had got married/remarried or who had partner(OR=0.689), people who had no family history of any mental disorders(OR=0.405). Conclusions Approximately 12% of Beijing residents may meet at least one diagnosis of mental disorder in their lifetime; The prevalence of mental disorders is associated with older age,female gender,lower level of education,rural dwelling,positive family history of mental disorders,and poor social support system.