Ohayon M M, Shapiro C M, Kennedy S H
Philippe Pinel Research Center of Montreal, Ontario.
Can J Psychiatry. 2000 Mar;45(2):166-72. doi: 10.1177/070674370004500207.
To attempt, for the first time, to apply a positive and differential diagnosis process in the general population during interviews using DSM-IV classification to ascertain the profile and occurrence of concomitant mental disorders.
A representative sample of 1832 individuals aged 15 years or older living in the metropolitan area of Toronto were interviewed by means of telephone interviews. The participation rate was 72.8%.
Overall, 13.2% (n = 242) of the sample had either a mood disorder (n = 127; 6.9%) or an anxiety disorder (n = 170; 9.3%) at the time of their interview. The prevalence was higher among women (16.5%) than among men (9.7%), with an odds ratio of 1.8. The comorbidity of mood and anxiety disorders was found in 3% (n = 55) of the sample. Less than one-third of respondents with a mood and/or anxiety disorder were being treated by a physician for a mental disorder. However, these individuals were greater consumers of health care services. Most of them consulted a physician an average of 5 times in the past year. Individuals on medication diagnosed with a mood and an anxiety disorder consulted a physician an average of 12 times in the past year. Only 13% of them were treated with antidepressants and under 9% with anxiolytics.
More than 70% of subjects with a mood disorder also complained of insomnia. With the differential process, 12% of the subjects manifesting a full-fledged anxiety disorder were diagnosed with only a mood disorder because the anxiety occurred only in the course of the mood disorder. About two-thirds of the subjects diagnosed in this study were undiagnosed and untreated by their physician.
首次尝试在访谈过程中对普通人群应用基于《精神疾病诊断与统计手册》第四版（DSM-IV）分类的阳性和鉴别诊断流程，以确定共病精神障碍的概况和发生率。
通过电话访谈对居住在大多伦多地区的1832名15岁及以上的个体进行了抽样调查，这些个体具有代表性。参与率为72.8%。
总体而言，样本中有13.2%（n = 242）在访谈时患有心境障碍（n = 127；6.9%）或焦虑障碍（n = 170；9.3%）。女性患病率（16.5%）高于男性（9.7%），优势比为1.8。在样本的3%（n = 55）中发现了心境障碍和焦虑障碍的共病情况。患有心境和/或焦虑障碍的受访者中，不到三分之一的人正在接受医生的精神障碍治疗。然而，这些人是医疗服务的更大消费者。他们中的大多数人在过去一年中平均看了5次医生。被诊断患有心境和焦虑障碍且正在服药的个体在过去一年中平均看了12次医生。他们中只有13%接受了抗抑郁药治疗，不到9%接受了抗焦虑药治疗。
超过70%的心境障碍患者也抱怨失眠。通过鉴别诊断流程，12%表现为完全性焦虑障碍的受试者仅被诊断为心境障碍，因为焦虑仅在心境障碍过程中出现。在本研究中被诊断的受试者中，约三分之二未被医生诊断和治疗。
