Lépine J-P, Gasquet I, Kovess V, Arbabzadeh-Bouchez S, Nègre-Pagès L, Nachbaur G, Gaudin A-F
INSERM U705, CNRS, UMR 7157, Universités Paris 5 et 7.
Encephale. 2005 Mar-Apr;31(2):182-94. doi: 10.1016/s0013-7006(05)82385-1.
ESEMeD is the first international epidemiological study using a random sampling method that has allowed the prevalence of psychiatric disorders in France to be measured with precision and compared directly with that observed in other European countries.
This was a transversal survey carried out between 2001 and 2003 of non-institutionalised subjects aged 18 or over in the general population of Germany (n = 3,555), Belgium (n = 2,419), Spain (n = 5,473), France (n = 2,894), the Netherlands (n = 2,372) and Italy (n = 4,712). In France, the sampling source was a randomly generated list of telephone numbers. Subjects were interviewed at home by professional interviewers. The WMH-CIDI questionnaire was used.
The participation rate was 46% for France and 61% for all six countries combined. The 12 month and lifetime prevalence rates observed were respectively 6.0% and 21,4% for major depressive episodes, 1.6% and 7.9% for dysthymia, 2.1% and 6.0% for the generalised -anxiety disorders, 1.2% and 3.0% for panic disorders, 0.6% and 1.8% for agoraphobia, 2.2% and 3.9% for post-traumatic stress disorder, 1.7% and 4.7% for social phobia, 4.7% and 11,6% for specific phobia, 0.5% and 4.1% for alcohol abuse and 0.3% and 1.6% for alcohol dependence. Mood disorders and anxiety disorders were significantly more frequent in women, whilst alcohol-related disorders were more frequent in men. The prevalence of all three types of disorder was lower in elderly subjects and in those living in a rural environment. Mood disorders and alcohol-related disorders were more frequent in individuals living alone and mood disorders more frequent in those without paid employment. 38% of subjects with mood disorder also presented an anxiety disorder or an alcohol-related disorder. The comorbidity of mood and anxiety disorders was more frequent in women, younger subjects and those living alone. The comorbidity rate in subjects with anxiety disorders was 26% and did not differ between genders. For alcohol-related disorders, there was a striking difference in comorbidity rate between men and women: 26% in the former and 67% in the latter.
This study underlines the high prevalence of mood disorders, anxiety disorders and alcohol-related disorders in France and demonstrates a high degree of comorbidity between them. For this reason, it is important to evaluate and take into account potential comorbidity in the management of individuals with psychiatric disorders.
欧洲精神疾病流行病学调查（ESEMeD）是第一项采用随机抽样方法的国际流行病学研究，该方法使法国精神疾病的患病率得以精确测量，并能直接与其他欧洲国家观察到的患病率进行比较。
1）确定心境障碍、焦虑障碍和酒精相关障碍的12个月患病率及终生患病率。2）估计这些障碍之间的共病情况。3）评估这些障碍潜在的人口统计学风险因素。
这是一项于2001年至2003年对德国（n = 3555）、比利时（n = 2419）、西班牙（n = 5473）、法国（n = 2894）、荷兰（n = 2372）和意大利（n = 4712）普通人群中18岁及以上非机构化受试者进行的横断面调查。在法国，抽样来源是随机生成的电话号码列表。受试者由专业访谈员在家中进行访谈。使用了世界精神卫生调查综合国际诊断访谈问卷（WMH-CIDI）。
法国的参与率为46%，六个国家的总参与率为61%。观察到的12个月患病率和终生患病率分别为：重度抑郁发作6.0%和21.4%，心境恶劣障碍1.6%和7.9%，广泛性焦虑障碍2.1%和6.0%，惊恐障碍1.2%和3.0%，广场恐惧症0.6%和1.8%，创伤后应激障碍2.2%和3.9%，社交恐惧症1.7%和4.7%，特定恐惧症4.7%和11.6%，酒精滥用0.5%和4.1%，酒精依赖0.3%和1.6%。心境障碍和焦虑障碍在女性中更为常见，而酒精相关障碍在男性中更为常见。所有三种类型的障碍在老年受试者和农村居住者中患病率较低。心境障碍和酒精相关障碍在独居个体中更为常见，心境障碍在无薪工作者中更为常见。38%的心境障碍受试者还患有焦虑障碍或酒精相关障碍。心境障碍和焦虑障碍的共病在女性、年轻受试者和独居者中更为常见。焦虑障碍受试者的共病率为26%，且无性别差异。对于酒精相关障碍，男性和女性的共病率存在显著差异：前者为26%，后者为67%。
本研究强调了法国心境障碍、焦虑障碍和酒精相关障碍的高患病率，并表明它们之间存在高度共病情况。因此，在管理精神疾病患者时评估并考虑潜在的共病情况很重要。
