精神疾病对普通人群的影响：生活满意度以及共病和疾病持续时间的影响。

Impact of psychiatric disorders in the general population: satisfaction with life and the influence of comorbidity and disorder duration.

作者信息

Meyer Christian, Rumpf Hans-Jürgen, Hapke Ulfert, John Ulrich

机构信息

Ernst-Moritz-Arndt-University of Greifswald, Institute of Epidemiology & Social Medicine, Walther-Rathenau-Str.48, 17487 Greifswald, Germany.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2004 Jun;39(6):435-41. doi: 10.1007/s00127-004-0755-3.

DOI:10.1007/s00127-004-0755-3

PMID:15205727

Abstract

BACKGROUND

Psychiatric disorders as defined by DSM-IV are found to be highly prevalent in the general population. However, little is known about aspects defining the burden caused by different disorders.

OBJECTIVES

The aim of this study was to evaluate the impact of different psychiatric disorders in the community with respect to life satisfaction taking into account the effects of comorbidity and disorder duration.

METHOD

Psychiatric 12-month disorders and life satisfaction were assessed in a random sample of 4075 adults from the general population using the Composite International Diagnostic Interview and the Satisfaction With Life Scale (SWLS). Separate analyses were performed for comorbid and pure disorders. Disorder duration was defined by the time since disorder onset for participants fulfilling diagnostic criteria within the last year.

RESULTS

SWLS scores were significantly lower for all diagnostic subgroups except for bipolar disorders, compared to subjects with no 12-month diagnosis. Effect sizes were medium to large. Comorbidity was significantly associated with lower satisfaction with life. Pure disorders are associated with less but still significantly reduced SWLS scores, except alcohol abuse, major depression and specific phobia. Mean duration of disorder was lowest for dysthymia (5.9 years) and highest for specific phobia (24.5 years). The only significant correlation between disorder duration and SWLS was found for major depression (r = -0.26) and no trend for the direction of the relation could be identified across disorders.

CONCLUSIONS

The impact of mental disorders in the community was confirmed by using the subjective measure of life satisfaction. Comorbidity is a key factor in determining the extent of reduction in satisfaction with life. Measures of disorder persistence should be examined by refined research strategies. Comprehensive analyses of mental disorders--exceeding the prevalence or a single measure of burden--have to be considered to define the most urgent needs in the community.

摘要

背景

《精神疾病诊断与统计手册》第四版（DSM-IV）所定义的精神疾病在普通人群中极为普遍。然而，对于不同精神疾病所造成负担的界定因素却知之甚少。

目的

本研究旨在评估不同精神疾病对社区生活满意度的影响，同时考虑共病和疾病持续时间的影响。

方法

使用复合国际诊断访谈和生活满意度量表（SWLS），对来自普通人群的4075名成年人随机样本进行了为期12个月的精神疾病和生活满意度评估。对共病和单纯性疾病分别进行了分析。疾病持续时间由过去一年内符合诊断标准的参与者自疾病发作以来的时间定义。

结果

与无12个月诊断的受试者相比，除双相情感障碍外，所有诊断亚组的SWLS评分均显著较低。效应大小为中等至较大。共病与较低的生活满意度显著相关。除酒精滥用、重度抑郁症和特定恐惧症外，单纯性疾病与SWLS评分降低幅度较小但仍显著相关。心境恶劣障碍的平均疾病持续时间最短（5.9年），特定恐惧症最长（24.5年）。仅在重度抑郁症中发现疾病持续时间与SWLS之间存在显著相关性（r = -0.26），且在所有疾病中均未发现该关系方向的趋势。