Abou-Saleh M T, Ghubash R, Daradkeh T K
Department of Addictive Behaviour & Psychological Medicine, St. George's Hospital Medical School, University of London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2001 Jan;36(1):20-8. doi: 10.1007/s001270050286.
Psychiatric community studies are essential for the planning and development of psychiatric services, as well as being helpful in examining the socio-demographic correlates of mental disorders in a given community. Few such studies have been carried out to date in the Arabian peninsula. This paper forms part of a multipurpose community psychiatric survey conducted in A1 Ain in the United Arab Emirates. The findings regarding lifetime prevalence and psychiatric morbidity are reported.
A total of 1394 (n = 1394) adults systematically sampled from Al Ain community were assessed with a modified version of the Composite International Diagnostic Interview (CIDI) as well with other instruments: the new screening psychiatric instrument, Self-Reporting Questionnaire (SRQ-20), and the Structured Clinical Interview for DSM-IV Axis 1 disorders (SCID) screening module. Lifetime prevalence and 1-week prevalence rates of mental distress as measured by screening instruments were estimated as well as the lifetime prevalence rate of CIDI ICD-10 psychiatric disorders. The sensitivity of the CIDI interview to correctly pick up distressed subjects, as well as those who had undergone previous treatment for a psychiatric disorder, was also calculated. Associations between socio-demographic risk factors and ICD-10 psychiatric disorder as well as with mental distress were also examined by bivariate and multivariate analyses.
Overall lifetime prevalence of ICD-10 psychiatric disorder was found to be 8.2% (95% CI: 6.7-9.7), while the 1-week prevalence rate of mental distress as measured by the SRQ-20 was 15.6% (95% CI: 11.8-19.5) and the lifetime prevalence rate of mental distress as measured by the new screening instrument was 18.9% (95% CI: 11.5-25.9). The CIDI interview correctly picked up 42% of subjects who had received previous psychiatric treatment and 51% of the distressed. Mood disorders and anxiety (neurotic) disorders were more common in women and alcohol and substance use disorders were exclusively confined to men. Female sex, young age, quality of marital relationship, life events over past year, chronic life difficulties, physical illness, family history of psychiatric disorders and past history of psychiatric treatment were found to be significantly associated with ICD-10 psychiatric disorder. Multivariate analysis revealed that age, sex, exposure to chronic difficulties and past history of psychiatric treatment were the most significant predictors of ICD-10 psychiatric disorders, and exposure to chronic difficulties, past history of psychiatric treatment and educational attainment were the significant predictors of lifetime ever and current mental distress.
The pattern and trend of psychiatric morbidity found in this survey is in line with those reported by other surveys that utilized similar assessment instruments. Differences in rates are explained by different methodologies used.
精神病社区研究对于精神卫生服务的规划与发展至关重要,同时有助于考察特定社区中精神障碍的社会人口学相关因素。迄今为止,阿拉伯半岛开展的此类研究较少。本文是在阿拉伯联合酋长国艾因市进行的一项多用途社区精神病学调查的一部分。报告了终生患病率和精神病发病率的调查结果。
从艾因社区系统抽样选取了1394名成年人,使用综合国际诊断访谈(CIDI)的修订版以及其他工具进行评估:新的筛查精神病学工具即自评问卷(SRQ-20),以及DSM-IV轴I障碍的结构化临床访谈(SCID)筛查模块。估计了筛查工具所测量的精神痛苦的终生患病率和1周患病率,以及CIDI ICD-10精神障碍的终生患病率。还计算了CIDI访谈正确识别痛苦受试者以及曾接受过精神障碍治疗者的敏感性。通过双变量和多变量分析,考察了社会人口学危险因素与ICD-10精神障碍以及与精神痛苦之间的关联。
发现ICD-10精神障碍的总体终生患病率为8.2%(95%可信区间:6.7 - 9.7),而SRQ-20所测量的精神痛苦的1周患病率为15.6%(95%可信区间:11.8 - 19.5),新筛查工具所测量的精神痛苦的终生患病率为18.9%(95%可信区间:11.5 - 25.9)。CIDI访谈正确识别了42%曾接受过精神治疗的受试者以及51%的痛苦受试者。情绪障碍和焦虑(神经症)障碍在女性中更为常见,而酒精和物质使用障碍仅见于男性个体。发现女性、年轻、婚姻关系质量、过去一年的生活事件、慢性生活困难、躯体疾病、精神障碍家族史以及既往精神治疗史与ICD-10精神障碍显著相关。多变量分析显示,年龄、性别、暴露于慢性困难以及既往精神治疗史是ICD-10精神障碍最显著的预测因素,而暴露于慢性困难、既往精神治疗史以及受教育程度是终生及当前精神痛苦的显著预测因素。
本次调查中发现的精神病发病率模式和趋势与其他使用类似评估工具的调查所报告的一致。发病率的差异可通过所采用方法的不同来解释。