云南省西盟佤族自治县精神障碍现况调查

摘要

目的：了解西盟佤族自治县精神障碍流行病学特征，探讨影响精神障碍患病率的心理社会危险因素。方法：采用多阶段抽样方法，抽取在西盟佤族自治县居住6个月以上年满18岁的各族居民2381人作为调查对象。以一般健康问卷（GHQ）作为筛查工具，以ICD-10症状清单作为诊断工具进行入户访谈。结果：任何一种精神障碍的终生患病率为19.86％（419／2110），使用精神活性物质（烟、酒）所致的精神和行为障碍为12.99％（274／2110），神经症、应激相关的及躯体形式障碍为6.30％（133／2110），非器质性睡眠障碍为2.94％（62／2110），心境障碍为2.32％（49／2110），精神分裂症为1.00％（21／2110）。多因素非条件logistic 分析结果显示，与神经症、应激相关的及躯体形式障碍有关的影响因素包括男性（OR＝0.43）、年龄较大（35～49岁，OR＝1.78；50～64岁，OR＝2.59；≥65岁，OR＝3.51）、未婚及其他婚姻状况（OR＝0.31）、非佤族及拉祜族民族（OR＝0.29）；与使用精神活性物质（烟、酒）所致的精神和行为障碍有关的影响因素包括男性（OR＝2.41）、年龄较大（35～49岁，OR＝2.29；50～64岁，OR＝3.20；≥65岁，OR＝4.58）、农民及个体户外的其他职业（OR＝0.41）及其他民族（OR＝0.32）；与心境障碍有关的影响因素包括男性（OR＝0.35）及年龄较大（≥65岁，OR＝3.05）。结论：西盟佤族自治县各类精神障碍的终生患病率、烟酒所致精神和行为障碍、焦虑障碍患病率较高，应加强少数民族地区精神障碍防控工作。%Objective:To describe the epidemiological characteristics of mental disorders in Ximeng Wa Au-tonomous County and explore psychosocial risk factors of mental disorders. Methods:Two thousand three hundred and eighty one residents aged 1 8 years and over were sampled using multistage sampling in Ximeng Wa Autono-mous County in 2013. All respondents were investigated by face-to-face interview. Mental disorders were screened out by using the General Health Questionnaire (GHQ)and diagnosed according to the International Classification of Diseases Checklist (ICD-10-Checklist)criteria. Results:Life time prevalence of any mental disorder was 19. 86%(419/2110). The lifetime prevalence rates of substance use disorder,anxiety disorder,insomnia,mood disorder, schizophrenia were 12. 99%(274/2110),6. 30%(133/2110),2. 94%(62/2110),2. 32%(49/2110)and 1. 00%(21/2110)respectively. Male (OR=0. 43),older age (35 -49 years,OR=1. 78;50 -64 years,OR=2. 59;≥65 years,OR=3. 5 1 ),unmarried and other marital status (OR=0. 3 1 ),non-Wa and non-Lahu ethnic groups (OR=0. 29)were associated with neurotic,stress-related and somatoform disorders. Male (OR=2. 41),older age (35 -49 years,OR=2. 29;50-64 years,OR=3. 20;≥65 years,OR=4. 58),non-farmer and non-self-employed occupation (OR=0. 41),and non-Wa and non-Lahu ethnic groups (OR=0. 32)were associated with psychoactive substance use disorder. Male (OR =0. 35 ) and order age (≥65 years,OR =3. 05 ) were associated with mood disorders. Conclusion:Lifetime prevalence of any mental disorder,substance use disorders and anxiety disorders are high in Ximeng Wa Autonomous County. Measures should be strengthened against prevalence of mental disorders in ethnic minority areas.