Research and Development Unit, Sant Joan de Déu - Serveis de Salut Mental, Red de Investigación en Actividades Preventivas y Promoción de la Salud en Atención Primaria, C/Doctor Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Barcelona, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2010 Feb;45(2):201-10. doi: 10.1007/s00127-009-0056-y. Epub 2009 May 19.
Previous epidemiological studies have revealed a high prevalence of mental disorders among primary care (PC) patients. However, most studies have methodological limitations (e.g. absence of structured clinical interviews, two-phase designs) that affect the generalizability of their results. The main objective of the present study was to estimate the lifetime and 12-month prevalence of mental disorders in the PC of Catalonia (Spain), using structured clinical interviews and a one-phase design.
One-phase cross-sectional survey. A representative probability sample without replacement of individuals aged 18 years or older attending PC for a medical visit were interviewed between October 2005 and March 2006. The interviews included SCID-I for depressive and anxiety disorders and the MINI interview for other mental disorders. A total of 3,815 patients from 77 PC centres were included in the statistical analyses.
45.1% of respondents reported at least one lifetime mental disorder and 30.2% reported at least one mental disorder in the previous 12 months. The most common mental disorders were major depression (9.6%), panic disorder (7.0%), specific phobia (6.6%), and generalized anxiety disorder (3.8%). There was a high comorbidity between mood and anxiety disorders, as well as between mental disorders and some chronic physical conditions.
There is a high prevalence and comorbidity of mental disorders in the PC of Catalonia. Public health policies should reinforce the role of family physicians in the detection and treatment of persons with mental disorders.
先前的流行病学研究表明,初级保健(PC)患者中心理障碍的患病率较高。然而,大多数研究都存在方法学上的局限性(例如,缺乏结构化的临床访谈、两阶段设计),这影响了其结果的普遍性。本研究的主要目的是使用结构化临床访谈和单阶段设计,估计加泰罗尼亚(西班牙)PC 中心心理障碍的终身和 12 个月患病率。
单阶段横断面调查。对 2005 年 10 月至 2006 年 3 月期间因医疗就诊而参加 PC 的 18 岁及以上个体进行无替换的代表性概率抽样,并对其进行访谈。访谈包括用于抑郁和焦虑障碍的 SCID-I 以及用于其他精神障碍的 MINI 访谈。共有来自 77 个 PC 中心的 3815 名患者纳入统计分析。
45.1%的受访者报告至少有一个终身精神障碍,30.2%的受访者报告在过去 12 个月内至少有一种精神障碍。最常见的精神障碍是重度抑郁症(9.6%)、惊恐障碍(7.0%)、特定恐惧症(6.6%)和广泛性焦虑障碍(3.8%)。情绪和焦虑障碍之间以及精神障碍与某些慢性躯体疾病之间存在很高的共病性。
加泰罗尼亚的 PC 中心存在很高的精神障碍患病率和共病性。公共卫生政策应加强家庭医生在发现和治疗精神障碍患者方面的作用。