Cwikel Julie, Zilber Nelly, Feinson Marjorie, Lerner Yaacov
Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, Beer Sheva, Israel 84105.
Soc Psychiatry Psychiatr Epidemiol. 2008 Mar;43(3):184-91. doi: 10.1007/s00127-007-0286-9. Epub 2007 Nov 16.
Prevalence rates of mental health problems in primary care vary according to population and the type of measure used. This study examined the prevalence of a full range of mental health problems, including sub-threshold diagnoses, and the socio-demographic risk factors for psychiatric disorders among a population with low out-of-pocket expenditures for medical care.
Four validated mental health assessment instruments, including the CIDI-SF, were administered to a sample of 976 users of primary care in Israel between the ages of 25-75 in eight clinics throughout the country. Prevalence estimates were obtained for seven psychiatric diagnoses, two "other mental health disorders" (somatization and disordered eating) and five sub-threshold conditions.
The most common types of morbidity were depression and disordered eating (20.6% and 15.0%, respectively), followed by somatization (11.8%) and general anxiety (11.2%). Among respondents, 31.1% had at least one psychiatric diagnosis, 24.3% had 'other mental disorders' and 15.5% had sub-threshold conditions. Panic attack, disordered eating and somatization, as well as a global measure of any psychiatric diagnosis were significantly more prevalent among women than men. Psychiatric diagnoses were also more common among those in the age group 45-64, with less education and insufficient income, the never married and separated/divorced and those not working. No significant differences were found between recent immigrants, veteran immigrants and Israeli-born, between Arab and Jewish Israelis or between secular or religious sectors of the population.
This study establishes the prevalence of the most common disorders in primary care including PTSD, somatization and disordered eating behaviors. The additional of other mental disorders suggests that a more accurate picture of mental disorders in primary care requires an expanded assessment procedure.
基层医疗中精神健康问题的患病率因人群和所采用的测量类型而异。本研究调查了一系列精神健康问题的患病率，包括阈下诊断，以及医疗自费支出较低人群中精神障碍的社会人口学风险因素。
对以色列全国8家诊所的976名年龄在25 - 75岁之间的基层医疗使用者样本，使用包括CIDI - SF在内的四种经过验证的精神健康评估工具。获得了七种精神疾病诊断、两种“其他精神健康障碍”（躯体化和饮食失调）以及五种阈下状况的患病率估计值。
最常见的发病类型是抑郁症和饮食失调（分别为20.6%和15.0%），其次是躯体化（11.8%）和广泛性焦虑（11.2%）。在受访者中，31.1%至少有一种精神疾病诊断，24.3%有“其他精神障碍”，15.5%有阈下状况。惊恐发作、饮食失调和躯体化，以及任何精神疾病诊断的综合测量在女性中比男性更普遍。精神疾病诊断在45 - 64岁年龄组、受教育程度较低、收入不足、未婚、分居/离婚以及未工作的人群中也更为常见。在新移民、老移民和以色列本土出生者之间，阿拉伯裔和犹太裔以色列人之间，或人口的世俗或宗教部门之间未发现显著差异。
本研究确定了基层医疗中最常见疾病的患病率，包括创伤后应激障碍、躯体化和饮食失调行为。纳入其他精神障碍表明，要更准确地了解基层医疗中的精神障碍，需要扩大评估程序。
