Puertas Gloria, Ríos Cielo, del Valle Hernán
Coordinadora regional de salud del Alto Comisionado para los Refugiados (ACNUR) para el sur de Africa; C/ Pedro IV n 68, 2 Derecha, 22002 Huesca, Spain.
Rev Panam Salud Publica. 2006 Nov;20(5):324-30. doi: 10.1590/s1020-49892006001000005.
To investigate the prevalence of common mental disorders in groups with a high percentage of families who have been displaced by armed conflict and political instability and are living in urban slum areas on the outskirts of Sincelejo, a city in the department of Sucre, Colombia.
A cross-sectional study was conducted, with two-stage random cluster sampling, in slum neighborhoods of Sincelejo that contain a high percentage of displaced persons. A household survey of persons 18 years old or older was used to determine the presence of common mental disorders-psychosomatic disorders, anxiety, and depression-in the population studied. A score of 7 or more on the first 20 questions of the Self-Reporting Questionnaire (SRQ) of the World Health Organization was used to determine the presence of a common mental disorder. We searched for associations among the studied variables (age group, gender, type of health care card, and length of residence in the neighborhood) and among those variables and the score on the SRQ. The chi-square test was used, with statistical significance set at 0.05. Logistic regression was carried out with all the related variables.
The prevalence of common mental disorders in the adult population of the neighborhoods studied was 27.2% (95% confidence interval (95% CI)=24.0% to 30.0%); 13.6% (95% CI=11.4% to 16.1%) of the population surveyed had problems with excessive alcohol consumption. There was an association between the prevalence of common mental disorders and the type of health care card used (odds ratio=1.66 for persons using the health care card for displaced persons versus persons using other types of health care cards). In addition, there was an association between the prevalence of common mental disorders and gender (OR=1.78 for women); this association remained after adjusting for other explanatory variables.
Using the study criteria (type of health care card and length of time living in the slum area), it was difficult to separate the displaced persons from other persons living in the same slum areas, and thus to measure the prevalence of common mental disorders among just the displaced persons. The prevalence of common mental disorders in the urban population studied showed a statistical association with the type of health care card, which in turn determined the level of access to public health services. This association between the type of health care card held and the prevalence of common mental disorders is strong enough to justify providing mental health care services to persons who have the health care card for displaced persons.
调查在哥伦比亚苏克雷省锡塞莱霍市郊区城市贫民窟地区生活的群体中常见精神障碍的患病率，这些群体中有很大比例的家庭因武装冲突和政治动荡而流离失所。
采用两阶段随机整群抽样方法，在锡塞莱霍市贫民窟社区进行横断面研究，这些社区中有很大比例的流离失所者。对18岁及以上人群进行家庭调查，以确定所研究人群中是否存在常见精神障碍——身心障碍、焦虑和抑郁。使用世界卫生组织自填问卷（SRQ）前20个问题中得分7分及以上来确定是否存在常见精神障碍。我们研究了所研究变量（年龄组、性别、医疗保健卡类型和在社区居住时间）之间以及这些变量与SRQ得分之间的关联。采用卡方检验，设定统计学显著性水平为0.05。对所有相关变量进行逻辑回归分析。
在所研究社区的成年人群中，常见精神障碍的患病率为27.2%（95%置信区间（95%CI）=24.0%至30.0%）；接受调查的人群中有13.6%（95%CI=11.4%至16.1%）存在过度饮酒问题。常见精神障碍患病率与所使用的医疗保健卡类型之间存在关联（使用流离失所者医疗保健卡的人与使用其他类型医疗保健卡的人相比，优势比=1.66）。此外，常见精神障碍患病率与性别之间存在关联（女性的优势比=1.78）；在对其他解释变量进行调整后，这种关联仍然存在。
根据研究标准（医疗保健卡类型和在贫民窟地区居住时间），很难将流离失所者与居住在同一贫民窟地区的其他人区分开来，因此难以仅测量流离失所者中常见精神障碍的患病率。在所研究的城市人群中，常见精神障碍患病率与医疗保健卡类型存在统计学关联，而医疗保健卡类型又决定了获得公共卫生服务的水平。持有医疗保健卡类型与常见精神障碍患病率之间的这种关联足够强，足以证明应为持有流离失所者医疗保健卡的人提供心理健康服务。
