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印度马哈拉施特拉邦浦那市精神障碍的流行病学研究。

An epidemiological study of mental disorders at pune, maharashtra.

作者信息

Deswal Balbir S, Pawar A

机构信息

Station Health Organisation (Army) Meerut Cantt., Uttar Pradesh, India.

出版信息

Indian J Community Med. 2012 Apr;37(2):116-21. doi: 10.4103/0970-0218.96097.

Abstract

BACKGROUND

The WHO Global Burden of Disease study estimates that mental and addictive disorders are among the most burdensome in the world, and their burden will increase over the next decades. The mental and behavioral disorders account for about 12% of the global burden of disease. However, these estimates and projections are based largely on literature review rather than cross-national epidemiological surveys. In India, little is known about the extent, severity and unmet need of treatment mental disorders. Thus, there was a need to carry out rigorously implemented general population surveys that estimate the prevalence of mental disorders among urban population at Pune, Maharashtra. The study attempted to address unmet need and to form a basis for formulating the mental health need of the community.

OBJECTIVE

The study was undertaken to estimate the lifetime prevalence and 12 month prevalence of specific mental disorders in urban population, socio-demographic correlates of mental disorders and to assess the service utilization in individuals with mental disorders.

MATERIALS AND METHODS

The study was undertaken among adults aged 18 years and above living in house hold and in geographical area of Pune , Maharashtra. A minimum sample of 3000 completed interviews was planned using representative probabilities to population size (PPS) sampling method which ensured equal probability for every eligible member. Data listing was obtained from Census Office from recent census of 2001 data. The face to face interviews were undertaken in homes using fully structured interview schedule of World Mental Health Survey Initiative duly revised Version of WHO- Composite International Diagnostic Interview (CIDI 3.0) by trained investigators. Clinical reappraisal was carried out using Schedules for Clinical Assessment in Neuropsychiatry (SCAN) among ten percent of diagnosed cases selected randomly. Data were entered into DDE (Blaize Software) and analyzed using SPSS software package.

RESULTS

Overall lifetime prevalence of mental disorders was found to be 5.03%.Rates among males (5.30%) were higher as compared to females (4.73%). Among the diagnostic group , depression(3.14%) was most prevalent followed by substance use disorder (1.39%) and panic disorder (0.86%). Overall 12 month prevalence of mental disorder was found to be 3.18% which was 3.47% among males and 2.85% among females. Prevalence of depression (1.75%) was the most 12-month mental disorder, followed by substance use mental disorder (0.99%) and panic disorder (0.69%).Lifetime and twelve month prevalence of any mental disorder was the highest among employed group, followed by home makers and depression was more among married, followed by separated/divorced/widowed group and the least in unmarried group in the study. Treatment gap due to low prescription received indicated the most of the ill person did not acknowledge their need for treatment or do not received the appropriate care.

CONCLUSION

The figure of 5.03% prevalence of diagnosable psychiatric disorders in adult population points to the great need to increase the prevention strategies both at primary and secondary level to overcome the disability and economic loss to society due to mental disorders.

摘要

背景

世界卫生组织全球疾病负担研究估计,精神和成瘾性障碍是世界上负担最为沉重的疾病之一,且在未来几十年其负担将会增加。精神和行为障碍约占全球疾病负担的12%。然而,这些估计和预测很大程度上基于文献综述而非跨国流行病学调查。在印度,对于精神障碍的程度、严重程度及未满足的治疗需求知之甚少。因此,有必要开展严格实施的普通人群调查,以估计马哈拉施特拉邦浦那市城市人口中精神障碍的患病率。该研究试图解决未满足的需求,并为制定社区心理健康需求奠定基础。

目的

本研究旨在估计城市人口中特定精神障碍的终生患病率和12个月患病率、精神障碍的社会人口学相关因素,并评估精神障碍患者的服务利用情况。

材料与方法

本研究在居住于马哈拉施特拉邦浦那市家庭及地理区域内的18岁及以上成年人中进行。计划采用与人口规模成比例的概率抽样方法(PPS抽样法)完成至少3000份访谈,以确保每个符合条件的成员具有平等概率。数据列表取自2001年最新人口普查的人口普查办公室。由经过培训的调查员使用世界心理健康调查倡议经过适当修订的世界卫生组织综合国际诊断访谈(CIDI 3.0)的完全结构化访谈时间表在家庭中进行面对面访谈。在随机选择的10%已确诊病例中,使用神经精神病学临床评估时间表(SCAN)进行临床重新评估。数据录入DDE(Blaize软件)并使用SPSS软件包进行分析。

结果

发现精神障碍的总体终生患病率为5.03%。男性患病率(5.30%)高于女性(4.73%)。在诊断组中,抑郁症(3.14%)最为普遍,其次是物质使用障碍(1.39%)和惊恐障碍(0.86%)。精神障碍的总体12个月患病率为3.18%,其中男性为3.47%,女性为2.85%。抑郁症(1.75%)是最常见的12个月精神障碍,其次是物质使用精神障碍(0.99%)和惊恐障碍(0.69%)。在本研究中,任何精神障碍的终生患病率和12个月患病率在就业群体中最高,其次是家庭主妇,抑郁症在已婚人群中更为常见,其次是分居/离婚/丧偶群体,在未婚群体中最少。由于处方量低导致的治疗差距表明,大多数患者未认识到自己的治疗需求或未得到适当护理。

结论

成年人口中可诊断精神障碍患病率为5.03%,这表明迫切需要在初级和二级层面加强预防策略,以克服精神障碍给社会带来的残疾和经济损失。

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