新疆维吾尔自治区精神障碍流行病学调查及影响因素研究
Epidemiological survey of the prevalence and associated factors of mental disorders in Xinjiang Uygur Autonomous Region
蒋良 李浩浩 邢文龙 张桂青 葛安心 胡敏 孟瑶
作者信息
摘要
背景 经济社会的发展、生活方式的转变及新型冠状病毒感染疫情的发生都对人群心身健康水平产生影响，进而可能使精神障碍的患病情况发生变化。然而，目前新疆维吾尔自治区的精神障碍流行病学调查资料尚不完善。目的 调查新疆维吾尔自治区北部（北疆）≥ 15 岁人群的常见精神障碍患病率及影响因素，并同新疆维吾尔自治区南部（南疆）相关资料进行汇总与对比，得出全疆常见精神障碍患病情况，为制定相应的精神卫生规划提供科学依据。方法 于 2021 年 11 月至 2022 年 7 月，采用多阶段分层整群随机抽样法在北疆选取居民 3 853 例为研究对象。以社会人口学调查表、自评量表（一般用健康问卷、心境障碍问卷、90 项症状清单等）及他评量表（汉密尔顿抑郁量表、贝克 - 拉范森躁狂量表、简易精神状态量表等）作为调查工具，以国际疾病分类第 10 版（ICD-10）中的精神与行为障碍分类为诊断标准，由两名具有≥ 5 年工作经验的精神科医师对纳入居民进行精神障碍诊断，诊断不一致者由精神科主任或副主任医师进行二次诊断。结果 北疆地区常见精神障碍时点患病率为 9.71%（374/3 853），年龄调整率为 10.07%；全疆常见精神障碍时点患病率为 9.69%（750/7 736），年龄调整率为 9.90%。其中，心境障碍、焦虑障碍、精神分裂症、器质性精神障碍、精神发育迟滞的时点患病率分别为 4.83%（374/7736）、3.63%（281/7736）、0.63%（49/7736）、0.23%（18/7736）、0.36%（28/7736）。针对北疆地区的多因素 Logistic 回归分析结果显示：女性患心境障碍的风险是男性的 1.854 倍〔95%CI（1.325，2.593）〕，25~34、35~44 岁者患心境障碍的风险分别是≥ 65 岁者的5.210倍〔95%CI（1.348，20.143）〕和 3.863 倍〔95%CI（1.030，14.485）〕，高中 / 中专、大专及以上文化程度者患心境障碍的风险分别是文盲的 0.199 倍〔95%CI（0.078，0.509）〕和 0.147 倍〔95%CI（0.056，0.388）〕；女性患焦虑障碍的风险是男性的 1.627 倍〔95%CI（1.144，2.315）〕，年龄为 15~24、45~54、55~64 岁者患焦虑障碍的风险分别是≥ 65 岁者的 0.257 倍〔95%CI（0.091，0.729）〕、0.243 倍〔95%CI（0.101，0.583）〕、0.210 倍〔95%CI（0.067，0.661）〕；居住在乡镇者患精神分裂症的风险是居住在城市者的 4.762 倍〔95%CI（1.705，1.300）〕，高中 / 中专文化程度者患精神分裂症的风险是文盲的 0.079 倍〔95%CI（0.015，0.405）〕。结论 新疆各类精神障碍中心境障碍和焦虑障碍的患病率较高，北疆地区女性、农村、低学历群体为患各类精神障碍的主要人群。
Abstract
BackgroundSocioeconomic developmentlifestyle changes and the COVID-19 pandemic all have an impact on people's mental and physical healthwhich may affect the prevalence of mental disorders. Currentlythere is still no sufficient epidemiological information of mental disorders in Xinjiang. ObjectiveTo investigate the prevalence and influencing factors of common mental disorders among people aged 15 and above in northern Xinjiangthen compare the data with those of their counterparts in southern Xinjiangand summarize the overall prevalence of common mental disorders in Xinjiangproviding a scientific basis for the formulation of corresponding mental health plans. MethodsFrom November 2021 to July 2022a multistagestratifiedcluster random sampling method was used to select 3 853 residents from northern Xinjiang to attend a survey. General Demographic Questionnaireand self-assessment scalesthe 12-Item General Health QuestionnaireMood Disorder QuestionnaireSymptom Checklist-90etc. and other assessment scalesHamilton Depression InventoryBechRafaelsen Mania Rating ScaleBrief Psychiatric Rating Scaleetc. were used as survey instruments. Mental disorders were diagnosed by the ICD-10 classification of mental and behavioral disorders by two psychiatrists with at least five years' working experienceor by a chief or associate chief psychiatrist when there is an inconsistency between the diagnoses made by the two psychiatrists. ResultsThe point prevalence rate and age-adjusted rate of common mental disorders in northern Xinjiang were 9.71%374/3 853 and 10.07%respectively. The point prevalence rate and age-adjusted rate of common mental disorders in the whole Xinjiang were 9.69%750/7 736and 9.90%respectively. The point prevalence rates of mood disordersanxiety disordersschizophreniaorganic mental disordersand mental retardation in northern Xinjiang were 4.83%374/7 7363.63%281/7 7360.63%49/7 7360.23%18/7 736and 0.36%28/7 736respectively. Multivariate Logistic regression analysis for northern Xinjiang showed thatthe risk of mood disorders in females was 1.854 times higher than that in males95%CI1.3252.593The risk of mood disorders increased by 5.210 times in 25-34-year-olds95%CI1.34820.143 and 3.863 times in 35-44-year-olds 95%CI1.03014.485 compared with that in those aged ≥ 65 yearsThe risk of mood disorders increased by 0.199 times in those with high school or technical secondary school education95%CI0.0780.509 and 0.147 times in those with two- or three-year college and above education95%CI0.0560.388 compared with that in illiteracies. The risk of anxiety disorder in females was 1.627 times higher than that in males95%CI1.1442.315The risk of anxiety disorder increased by 0.257 times in 15-24-year-olds95%CI0.0910.7290.243 times in 45-54-year-olds95%CI0.1010.583and 0.210 times in 55-64-year-olds95%CI0.0670.661 compared to that of those aged ≥ 65 years old. The risk of schizophrenia among people living in villages or towns was 4.762 times higher than that of those living in cities95%CI1.7051.300The risk of schizophrenia among people with high school or technical secondary school education was 0.079 times higher than that of illiteracies95%CI0.0150.405. ConclusionThe prevalence of mood disorders and anxiety disorders is high among all types of mental disorders in Xinjiang. Femalesrural peopleor low educated people in northern Xinjiang are more prone to various types of mental disorders.关键词
精神障碍/患病率/影响因素研究/心境障碍/焦虑障碍/精神分裂症/新疆维吾尔自治区Key words
Mental disorders/Prevalence/Root cause analysis/Mood disorder/Anxiety disorders/Schizophrenia/Xinjiang引用本文复制引用
蒋良,李浩浩,邢文龙,张桂青,葛安心,胡敏,孟瑶.新疆维吾尔自治区精神障碍流行病学调查及影响因素研究[EB/OL].(2023-04-10)[2026-04-01].https://chinaxiv.org/abs/202304.00985.学科分类
神经病学、精神病学
评论