[环境门诊患者的精神障碍——来自德国多中心多重化学敏感性（MCS）研究的标准化精神科访谈（复合性国际诊断交谈检查表，CIDI）结果]

[Psychiatric disorders of environmental outpatients--results of the standardized psychiatric interview (CIDI) from the German multi-center study on Multiple Chemical Sensitivity (MCS)].

作者信息

Dietel Anne, Jordan Lars, Mühlinghaus Tilman, Eikmann Thomas F, Herr Caroline E W, Nowak Dennis, Pedrosa Gil Francisco, Podoll Klaus, Wiesmüller Gerhard A, Eis Dieter

机构信息

Robert Koch-Institut, Fachgebiet 22/Umweltmedizin, Berlin.

出版信息

Psychother Psychosom Med Psychol. 2006 Mar-Apr;56(3-4):162-71. doi: 10.1055/s-2005-915346.

DOI:10.1055/s-2005-915346

PMID:16802422

Abstract

BACKGROUND

A nationwide, environmental outpatient-based multi-center two-phase study on Multiple Chemical Sensitivity (MCS) was conducted from 1999 until 2004. The aim of the study was to characterize more precisely the health-complaints relevant for the MCS-phenomenon. A standardized psychiatric interview (CIDI), used to identify frequency, character and duration of psychiatric disorders and their chronological relation to the environment-related health complaints of the patients, formed part of the extensive diagnostic procedure.

METHOD

251 (86.3%) of the 291 attendees of the environmental outpatient departments in Aachen, Berlin, Bredstedt, Freiburg, Giessen and Munich, were examined using the German version (M-CIDI/DIA-X) of the Composite International Diagnostic Interview.

RESULTS

83.7% (lifetime prevalence rate) fulfilled the diagnostic criteria of at least one psychiatric disorder, with the 12-month and 4-week prevalence rates being 76.5% and 64.5%, respectively. Environmental outpatients, in all prevalence periods, had significantly higher rates of psychiatric disorders than the comparable general population. Somatoform disorders were most frequently diagnosed, followed by depressive and phobic disorders. For 81.2% of the patients the psychiatric disorder started long before the environment-related health complaints (average 17 years).

CONCLUSIONS

This study confirms the results of earlier studies, i.e. that patients with environment-related health complaints suffer from psychiatric disorders more frequently than the general population. The high environmental outpatients really suffer from psychosomatic complaints, but attribute the causes to the environment. Application of specific therapeutic regimen is recommended for those patients, whose psychiatric disorders are safeguarded diagnostically and for whom a relevant exposure is unlikely.

摘要

背景

1999年至2004年开展了一项全国性的、基于环境门诊的多中心两阶段多重化学敏感性（MCS）研究。该研究的目的是更精确地描述与MCS现象相关的健康投诉。一项标准化的精神病学访谈（复合国际诊断访谈，CIDI）用于确定精神障碍的频率、特征和持续时间，以及它们与患者环境相关健康投诉的时间关系，这是广泛诊断程序的一部分。

方法

使用复合国际诊断访谈的德文版（M-CIDI/DIA-X）对亚琛、柏林、布雷德施泰特、弗赖堡、吉森和慕尼黑环境门诊的291名就诊者中的251名（86.3%）进行了检查。

结果

83.7%（终生患病率）符合至少一种精神障碍的诊断标准，12个月患病率和4周患病率分别为76.5%和64.5%。在所有患病率期间，环境门诊患者的精神障碍患病率均显著高于可比的普通人群。躯体形式障碍的诊断最为常见，其次是抑郁和恐惧症。81.2%的患者精神障碍在与环境相关的健康投诉之前很久就已出现（平均17年）。