School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia.
Aust N Z J Psychiatry. 2012 Aug;46(8):735-52. doi: 10.1177/0004867412449877. Epub 2012 Jun 13.
The 2010 Survey of High Impact Psychosis (SHIP) is Australia's second national psychosis survey. This paper provides an overview of its findings, including comparisons with the first psychosis survey and general population data.
The survey covered 1.5 million people aged 18-64 years, approximately 10% of Australians in this age group. A two-phase design was used. In phase 1, screening for psychosis took place in public mental health services and non-government organizations supporting people with mental illness. In phase 2, 1825 of those screen-positive for psychosis were randomly selected and interviewed. Data collected included symptomatology, substance use, functioning, service utilization, medication use, education, employment, housing, and physical health including fasting blood samples.
The estimated 1-month treated prevalence of psychotic disorders in public treatment services was 3.1 people per 1000 population; the 12-month treated prevalence was 4.5 people per 1000. The majority (63.0%) of participants met ICD-10 criteria for schizophrenia/schizoaffective disorder. One-half (49.5%) reported attempting suicide in their lifetime and two-thirds (63.2%) were rated as impaired in their ability to socialize. Over half (54.8%) had metabolic syndrome. The proportion currently smoking was 66.1%. Educational achievement was low. Only 21.5% were currently employed. Key changes in the 12 years since the first survey included: a marked drop in psychiatric inpatient admissions; a large increase in the proportion attending community mental health clinics; increased use of rehabilitation services and non-government organizations supporting people with mental illness; a major shift from typical to atypical antipsychotics; and large increases in the proportions with lifetime alcohol or drug abuse/dependence.
People with psychotic illness face multiple challenges. An integrated approach to service provision is needed to ensure that their living requirements and needs for social participation are met, in addition to their very considerable mental and physical health needs.
2010 年澳大利亚高影响力精神病学调查（SHIP）是该国的第二次全国精神病学调查。本文提供了其调查结果的概述，包括与第一次精神病学调查和一般人群数据的比较。
该调查涵盖了 150 万 18-64 岁的人群，约占该年龄段澳大利亚人口的 10%。采用了两阶段设计。在第一阶段，在公共心理健康服务机构和支持精神疾病患者的非政府组织中进行精神病筛查。在第二阶段，从筛查阳性的人群中随机抽取 1825 人进行访谈。收集的数据包括症状、物质使用、功能、服务利用、药物使用、教育、就业、住房以及包括空腹血样在内的身体健康。
公共治疗服务中，1 个月经治疗的精神病性障碍患病率估计为每 1000 人中有 3.1 人；12 个月经治疗的患病率为每 1000 人中有 4.5 人。大多数（63.0%）参与者符合 ICD-10 精神分裂症/分裂情感障碍标准。有一半（49.5%）报告在其一生中曾试图自杀，三分之二（63.2%）被评定为社交能力受损。超过一半（54.8%）患有代谢综合征。目前吸烟的比例为 66.1%。教育程度低。仅有 21.5%的人目前就业。与第一次调查相隔 12 年以来的主要变化包括：精神科住院人数显著下降；到社区心理健康诊所就诊的比例大幅增加；康复服务和支持精神疾病患者的非政府组织的使用增加；从典型抗精神病药到非典型抗精神病药的重大转变；以及终生酒精或药物滥用/依赖的比例大幅增加。
精神病患者面临多种挑战。需要采取综合的服务提供方法，以确保满足他们的生活需求和社会参与需求，以及他们的身心健康需求。
