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肯尼亚一家初级卫生保健中心精神障碍的患病率、类型及共病情况

Prevalence, types and comorbidity of mental disorders in a Kenyan primary health centre.

作者信息

Aillon Jean-Louis, Ndetei David M, Khasakhala Lincoln, Ngari Washington Njogu, Achola Hesbon Otieno, Akinyi Selestine, Ribero Simone

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2014 Aug;49(8):1257-68. doi: 10.1007/s00127-013-0755-2.

Abstract

PURPOSE

To estimate the prevalence, types and comorbidity of the most common mental disorders and the spread of suicide risk in a primary care practice in Kenya.

METHODS

This was a cross-sectional descriptive study. A total of 300 adult outpatients were randomly selected while they were consulting their general practitioner. The M.I.N.I. Plus interview five was used to diagnose psychiatric disorders and suicide risk.

RESULTS

Thus, 56.3 % of the sample (n = 169) presented one or more psychiatric disorders. The most prevalent disorders were Affective (39.0 %), Anxiety (31.3 %), and Somatoform (13.0 %). Regarding specific disorders, the most common were Major Depressive Disorder (26.3 %), Agoraphobia (16.7 %), Pain Disorder (12.5 %), Generalized Anxiety Disorder (9.3 %) and Bipolar Disorder (9 %). We found three cases of Bulimia Nervosa (1 %); 29.7 % had more than one current mental disorder. Suicide risk was present in 12.7 % of participants. No associations were identified between socio-demographic factors and the presence of mental disorder. Suicide risk was higher in women and in patients who came from slum areas. Gastric pain was positively associated with presence of mental disorder.

CONCLUSION

High prevalence of mental disorders and suicide risk calls for integrating mental health services in primary health care; in particular, this study highlights the importance of differentiating between specific types of mental disorders (which require different therapeutic approaches), and of diagnosing comorbidities.

摘要

目的

评估肯尼亚一家基层医疗诊所中最常见精神障碍的患病率、类型及共病情况,以及自杀风险的分布。

方法

这是一项横断面描述性研究。共随机选取300名成年门诊患者,他们当时正在咨询全科医生。采用MINI Plus访谈五来诊断精神障碍和自杀风险。

结果

因此,56.3%的样本(n = 169)存在一种或多种精神障碍。最常见的障碍是情感性障碍(39.0%)、焦虑性障碍(31.3%)和躯体形式障碍(13.0%)。具体疾病方面,最常见的是重度抑郁症(26.3%)、广场恐惧症(16.7%)、疼痛障碍(12.5%)、广泛性焦虑障碍(9.3%)和双相情感障碍(9%)。我们发现3例神经性贪食症(1%);29.7%的患者目前患有不止一种精神障碍。12.7%的参与者存在自杀风险。未发现社会人口学因素与精神障碍的存在之间存在关联。女性和来自贫民窟地区的患者自杀风险更高。胃痛与精神障碍的存在呈正相关。

结论

精神障碍和自杀风险的高患病率要求将心理健康服务纳入初级卫生保健;特别是,本研究强调了区分特定类型精神障碍(需要不同治疗方法)以及诊断共病的重要性。

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