赤峰市成人抑郁症现况调查
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摘要
目的:描述赤峰市抑郁症的患病率及其分布特点,并探讨相关危险因素。方法:以分层容量比例概率随机抽样的方法抽取赤峰市18岁及以上居民6376例,采用复合性国际诊断交谈表-3. 0-计算机版进行入户访谈,以美国精神障碍诊断与统计手册第4版为诊断标准诊断抑郁症。结果:4528人完成调查,抑郁症的加权终生患病率为4. 38%,加权12月患病率为1. 71%;抑郁症12月患病率女性高于男性(2. 11%vs. 1. 23%,P <0. 05),50～64岁年龄组高于18～34岁年龄组(2. 72%vs. 0. 92%,P <0. 01),≥65岁年龄组高于18～34岁年龄组(2. 65%vs. 0. 92%,P <0. 05);抑郁症首发年龄中位数为40 (4,80)岁;抑郁症患者求助精神科医生的比例仅为2. 4%。结论:赤峰市抑郁症患病率低于国外同类研究而与国内研究接近,女性及50岁以上群体有较高的患病风险。抑郁症患者求助精神科医生的比例不高,原因和对策值得进一步深入探讨。
Objective: To describe the prevalence of major depressive disorder( MDD) and distribution in Chifeng City,and explore related risk factors. Methods: Totally 6376 individuals aged 18 years and over were sampled by using stratified Probability-Proportional-to-Size sampling in Chifeng City. All respondents were interviewed by trained interviewers face-to-face. The Composite International Diagnostic Interview-3. 0 Computer Assisted Personal Interview( CIDI-3. 0-CAPI) was used to diagnose major depressive disorder by the criteria and definition of the fourth edition of Diagnostic and Statistical Manual of Mental Disorders of American Psychiatric Association. Results: Totally 4528 respondents were interviewed by using CIDI-3. 0-CAPI. The weighted lifetime and 12-month prevalence of MDD were 4. 38% and 1. 71%,respectively. The 12-month prevalence rate of MDD was higher in females than in males( 2. 11% vs. 1. 23%,P < 0. 05). The rates in age group of 50-64 years and age group of 65 years and over were significantly higher than that in age group of 18-34 years( 2. 72%vs. 0. 92%,P < 0. 01; 2. 65%vs. 0. 92%,P < 0. 05). The median onset age of MDD was 40( 4,80) years. It was found that only 2. 4% of the patients with MDD reported to seek help from psychiatrists. Conclusion: The prevalence of MDD is lower than the same kind survey abroad while it is close to the domestics. Women and people aged50 and over may have a higher chance of suffering MDD. Few people with MDD seek mental health professionals' help,the reasons and countermeasures are worthy of further discussion.
Objective: To describe the prevalence of major depressive disorder( MDD) and distribution in Chifeng City,and explore related risk factors. Methods: Totally 6376 individuals aged 18 years and over were sampled by using stratified Probability-Proportional-to-Size sampling in Chifeng City. All respondents were interviewed by trained interviewers face-to-face. The Composite International Diagnostic Interview-3. 0 Computer Assisted Personal Interview( CIDI-3. 0-CAPI) was used to diagnose major depressive disorder by the criteria and definition of the fourth edition of Diagnostic and Statistical Manual of Mental Disorders of American Psychiatric Association. Results: Totally 4528 respondents were interviewed by using CIDI-3. 0-CAPI. The weighted lifetime and 12-month prevalence of MDD were 4. 38% and 1. 71%,respectively. The 12-month prevalence rate of MDD was higher in females than in males( 2. 11% vs. 1. 23%,P < 0. 05). The rates in age group of 50-64 years and age group of 65 years and over were significantly higher than that in age group of 18-34 years( 2. 72%vs. 0. 92%,P < 0. 01; 2. 65%vs. 0. 92%,P < 0. 05). The median onset age of MDD was 40( 4,80) years. It was found that only 2. 4% of the patients with MDD reported to seek help from psychiatrists. Conclusion: The prevalence of MDD is lower than the same kind survey abroad while it is close to the domestics. Women and people aged50 and over may have a higher chance of suffering MDD. Few people with MDD seek mental health professionals' help,the reasons and countermeasures are worthy of further discussion.
引文
[1] 2013 DALYs and HALE Collaborator,Murray CJ,Barber RM,et al. Global,regional,and national disability-adjusted life years(DALYs)for 306 diseases and injuries and healthy life expectancy(HALE)for 188 countries,1990-2013:quantifying the epidemiological transition[J]. Lancet 2015,386(10009):2145-2191.
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[3]赤峰市统计局.赤峰市2016年国民经济和社会发展统计公报(2016)[R/OL].(2017)[2017-4-8]. http:∥www. tjcn. org/tjgb/05nmg/34949. html.
[4]李国华,黄悦勤,李艳祥,等.内蒙古赤峰市4类精神障碍现况调查[J].中国心理卫生杂志,2015,29(9):678-684.
[5]黄悦勤,谢守付,卢瑾,等.复合性国际诊断交谈表3. 0中文版在社区应用的信效度评价[J].中国心理卫生杂志,2010,24(1):21-24,28.
[6] Lu J,Huang YQ,Liu ZR,et al. Validity of Chinese Version of the Composite International Diagnostic Interview-3. 0 in psychiatric settings[J]. Chin Med J(Engl),2015,128(18):2462-2466.
[7] American Psychiatric Association. Diagnostic and Statistical Manuel of Mental Disorders(DSM-IV-R)[M]. Washington:American Psychiatric Association,1994.
[8]张维熙,李淑然,陈昌惠,等.中国七个地区精神疾病流行病学调查[J].中华精神科杂志,1998,31(2):5-7.
[9]王金荣,王德平,沈渔邨,等.中国七个地区情感性精神障碍流行病学调查[J].中华精神科杂志,1998,31(2):11-13.
[10]张维熙.国内十二地区精神疾病流行病学抽样调查研究[J].医学研究通讯,1986,15(6):187-188.
[11]胡斌,卢小勇,魏波,等.江西省抑郁症患病率的流行病学调查[J].中华精神科杂志,2003,36(4):53-56.
[12]姚坚,黄悦勤,阮冶,等.昆明市情感障碍流行病学调查[J].中国心理卫生杂志,2010,24(2):110-115.
[13]赵振环,黄悦勤,李洁,等.广州地区常住人口精神障碍的患病率调查[J].中国神经精神疾病杂志,2009,35(9):530-534.
[14]陈巧灵,谢守付,黄悦勤,等.大连市抑郁障碍的现况调查[J].医学与哲学(临床决策论坛版),2010,31(04):56-58.
[15]马贞玉,冯启明,陈强,等.广西壮族自治区城乡居民心境障碍流行病学调查[J].中国公共卫生,2012,28(12):1565-1568.
[16]刘肇瑞,黄悦勤,陈曦,等.北京市社区人群心境障碍、焦虑障碍及物质使用障碍的现况调查[J].中国心理卫生杂志,2013,27(2):102-110.
[17]Shen YC,Zhang MY,Huang YQ,et al. Twelve-month prevalence,severity,and unmet need for treatment of mental disorders in metropolitan China[J]. Psychol Med,2006,36(2):257-267.
[18]Kessler RC,Berglund P,Demler O,et al. The epidemiology of major depressive disorder:results from the National Comorbidity Survey Replication(NCS-R)[J]. JAMA,2003,289(23):3095-3105.
[19]Marneros A. Mood disorders:epidemiology and natural history[J].Psychiatry,2009,8(2):52-55.
[20]Chang SM,Hahm BJ,Lee JY,et al. Cross-national difference in the prevalence of depression caused by the diagnostic threshold.[J]. J Affect Disord,2008,106(1-2):159-167.
[21]Kessler RC,郭万军,曾卓谦,等.世界精神卫生调查行动及其对中国精神障碍流行病学研究的提示[J].中国神经精神疾病杂志,2010,36(7):385-388.
[22]González HM,Tarraf W,Whitfield KE,et al. The epidemiology of major depression and ethnicity in the United States[J]. J Psychiatr Res,2010,44(15):1043-1051.
[23]Waraich P,Goldner EM, Somers JM, et al. Prevalence and incidence studies of mood disorders:a systematic review of the literature[J]. Can J Psychiatry,2004,49(2):124-138.
[24]Kuehner C. Gender differences in unipolar depression:an update of epidemiological findings and possible explanations[J]. Acta Psychiatr Scand,2003,108(3):163-174.
[25]Desai HD,Jann MW. Major depression in women:a review of the literature[J]. J Am Pharmaceut Assoc,2000,40(4):525-537.
[26]丁丽君,王文强,廖震华,等.厦门市18岁及以上人群抑郁障碍流行病学调查[J].中国慢性病预防与控制,2013,21(5):526-529.
[27]崔青春,陈红梅,刘翠欣,等.河北省抑郁症的流行病学调查[J].临床精神医学杂志,2009,19(2):94-96.
[28]Kessler RC,Mcgonagle KA,Zhao S,et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey[J]. Arch Gen Psychiatry,1994,51(1):8-19.
[29]王晓明,刘启贵,许俊亭,等.大连地区居民自杀意念、自杀计划和自杀未遂的调查分析[J].四川精神卫生,2014,27(3):218-220.
[30]黄悦勤.我国精神卫生的现状和挑战[J].中国卫生政策研究,2011,4(9):5-9.
[2] Kassebaum NJ,Arora M,Barber RM, et al. Global, regional, and national disability-adjusted life-years(DALYs)for 315 diseases and injuries and healthy life expectancy(HALE),1990-2015:a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet 2016,388(10053):1603-1658.
[3]赤峰市统计局.赤峰市2016年国民经济和社会发展统计公报(2016)[R/OL].(2017)[2017-4-8]. http:∥www. tjcn. org/tjgb/05nmg/34949. html.
[4]李国华,黄悦勤,李艳祥,等.内蒙古赤峰市4类精神障碍现况调查[J].中国心理卫生杂志,2015,29(9):678-684.
[5]黄悦勤,谢守付,卢瑾,等.复合性国际诊断交谈表3. 0中文版在社区应用的信效度评价[J].中国心理卫生杂志,2010,24(1):21-24,28.
[6] Lu J,Huang YQ,Liu ZR,et al. Validity of Chinese Version of the Composite International Diagnostic Interview-3. 0 in psychiatric settings[J]. Chin Med J(Engl),2015,128(18):2462-2466.
[7] American Psychiatric Association. Diagnostic and Statistical Manuel of Mental Disorders(DSM-IV-R)[M]. Washington:American Psychiatric Association,1994.
[8]张维熙,李淑然,陈昌惠,等.中国七个地区精神疾病流行病学调查[J].中华精神科杂志,1998,31(2):5-7.
[9]王金荣,王德平,沈渔邨,等.中国七个地区情感性精神障碍流行病学调查[J].中华精神科杂志,1998,31(2):11-13.
[10]张维熙.国内十二地区精神疾病流行病学抽样调查研究[J].医学研究通讯,1986,15(6):187-188.
[11]胡斌,卢小勇,魏波,等.江西省抑郁症患病率的流行病学调查[J].中华精神科杂志,2003,36(4):53-56.
[12]姚坚,黄悦勤,阮冶,等.昆明市情感障碍流行病学调查[J].中国心理卫生杂志,2010,24(2):110-115.
[13]赵振环,黄悦勤,李洁,等.广州地区常住人口精神障碍的患病率调查[J].中国神经精神疾病杂志,2009,35(9):530-534.
[14]陈巧灵,谢守付,黄悦勤,等.大连市抑郁障碍的现况调查[J].医学与哲学(临床决策论坛版),2010,31(04):56-58.
[15]马贞玉,冯启明,陈强,等.广西壮族自治区城乡居民心境障碍流行病学调查[J].中国公共卫生,2012,28(12):1565-1568.
[16]刘肇瑞,黄悦勤,陈曦,等.北京市社区人群心境障碍、焦虑障碍及物质使用障碍的现况调查[J].中国心理卫生杂志,2013,27(2):102-110.
[17]Shen YC,Zhang MY,Huang YQ,et al. Twelve-month prevalence,severity,and unmet need for treatment of mental disorders in metropolitan China[J]. Psychol Med,2006,36(2):257-267.
[18]Kessler RC,Berglund P,Demler O,et al. The epidemiology of major depressive disorder:results from the National Comorbidity Survey Replication(NCS-R)[J]. JAMA,2003,289(23):3095-3105.
[19]Marneros A. Mood disorders:epidemiology and natural history[J].Psychiatry,2009,8(2):52-55.
[20]Chang SM,Hahm BJ,Lee JY,et al. Cross-national difference in the prevalence of depression caused by the diagnostic threshold.[J]. J Affect Disord,2008,106(1-2):159-167.
[21]Kessler RC,郭万军,曾卓谦,等.世界精神卫生调查行动及其对中国精神障碍流行病学研究的提示[J].中国神经精神疾病杂志,2010,36(7):385-388.
[22]González HM,Tarraf W,Whitfield KE,et al. The epidemiology of major depression and ethnicity in the United States[J]. J Psychiatr Res,2010,44(15):1043-1051.
[23]Waraich P,Goldner EM, Somers JM, et al. Prevalence and incidence studies of mood disorders:a systematic review of the literature[J]. Can J Psychiatry,2004,49(2):124-138.
[24]Kuehner C. Gender differences in unipolar depression:an update of epidemiological findings and possible explanations[J]. Acta Psychiatr Scand,2003,108(3):163-174.
[25]Desai HD,Jann MW. Major depression in women:a review of the literature[J]. J Am Pharmaceut Assoc,2000,40(4):525-537.
[26]丁丽君,王文强,廖震华,等.厦门市18岁及以上人群抑郁障碍流行病学调查[J].中国慢性病预防与控制,2013,21(5):526-529.
[27]崔青春,陈红梅,刘翠欣,等.河北省抑郁症的流行病学调查[J].临床精神医学杂志,2009,19(2):94-96.
[28]Kessler RC,Mcgonagle KA,Zhao S,et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey[J]. Arch Gen Psychiatry,1994,51(1):8-19.
[29]王晓明,刘启贵,许俊亭,等.大连地区居民自杀意念、自杀计划和自杀未遂的调查分析[J].四川精神卫生,2014,27(3):218-220.
[30]黄悦勤.我国精神卫生的现状和挑战[J].中国卫生政策研究,2011,4(9):5-9.