海南省15岁及以上人群抑郁障碍患病率及相关因素分析

摘要

目的 了解海南省15岁及以上人群抑郁障碍的患病率及相关因素.方法 2010年9月至2011年11月采用多阶段分层整群抽样方法随机抽取海南省6个县(市)、24个乡镇(街道)、59个村(居委会)中12 117人为调查对象,用扩展的一般健康问卷进行筛查,将调查对象分为精神障碍高、中、低3个风险组,再以DSM-Ⅳ轴Ⅰ障碍临床定式检查患者版对100％的高风险人群、40％的中风险人群及10％的低风险人群进行检查及精神障碍诊断,并根据3个风险组中诊断抑郁障碍现患(最近1个月)及终身患病的人数,计算样本的调整患病率、标化患病率及两类患病率的95％CI.采用卡方检验比较是否患抑郁障碍人群之间的差异,采用多因素Logistic回归分析抑郁障碍的相关因素,计算OR直及95％CI.结果 抑郁障碍现患病(最近1个月)人数97人,调整患病率为1.38％(95％CI:1.12～ 1.59);抑郁障碍终身患病人数为166人,调整患病率为2.80％(95％CI:2.51～ 3.09).多因素Logistic回归分析显示,女性(OR=1.55,95％CI:1.12～ 2.14)、年龄50～64岁(OR=1.84,95％CI:1.13～2.99)、离异/分居(0R=4.87,95％CI:1.86～ 12.73)、患慢性病(OR=2.19,95％CI:1.56～ 3.07)、家庭月收入低与抑郁障碍患病有关.结论 海南省居民抑郁障碍患病率较全国及其他省偏低,女性、年龄50～64岁、离异/分居人群、低收入及患慢性病是海南省抑郁障碍人群的影响因素.%Objective To investigate the prevalence and correlates of depression in residents aged 15 and older in Hainan province.Methods Stratified multistage random sampling methods were utilized to identify 12 117 individuals (≥15 years old) from 59 villages (neighborhoods) in 24 towns (streets) within 6 counties (cities) in Hainan Province from September 2010 to November 2011.The subjects were screened with an expanded version of the General Health Questionnaire (GHQ-12) and the respondents were divided into three groups by high risk,moderate risk and low risk of mental disorder,followed by formal diagnosis according to the Structured Clinical Interview for DSM-IV-TR (SCID-I/P) by psychiatrists among 100％ subjects in group with high risk,40％ subjects in group with moderate risk and 10％ subjects in group with low risk.The adjusted rate,standardized rate,and 95％ confidence interval (95％CI) of the one-month and lifetime prevalence were also calculated among the 3 groups of individuals who were diagnosed with depressive disorder.The difference in whether they suffered depression was determined by the chi-squared test.Correlations to depressive disorder and the odds ratio (OR) were explored with multiple regression analysis.Results There were 97 cases of depressive disorders (1-month) and 166 cases of lifetime depressive disorders finally confirmed.The adjusted rate of 1-month prevalence was 1.38％ (95％CI:1.12-1.59) and the life-time adjusted prevalence rate was 2.80％ (95％CI:2.51-3.09).Female (OR=1.55,95％CI:1.12-2.14),mid-age(50-64 y,OR=1.84,95％CI:1.13-2.99),being divorced or living separated (OR=4.87,95％CI:1.86-12.73),suffering chronic diseases (OR=2.19,95％CI:1.56-3.07),and low family income were significantly associated with suffering depressive disorder.Conclusions The prevalence of the depressive disorder among residents aged 15 and older in Hainan province is lower than the nationwide prevalence.People who are female,mid-age,being divorced or not living with the partner,earning a low income,and suffering chronic diseases have more predisposition to develop the depressive disorder in Hainan province.