Reister G, Tress W, Schepank H, Manz R, Sollors-Mossler B
Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim, FRG.
Psychother Psychosom. 1989;52(1-3):10-20. doi: 10.1159/000288260.
After discussing social issues of epidemiologic research on neurotic, character and psychosomatic disorders, we outline the main results of a field cohort study on 600 representative adults of Mannheim, a West German industrial city. According to ICD 300-307 (WHO 8th revision) and to a quantitative case definition clinically based on the severity of the symptoms we find an overall case rate of 26% in which females prevail over men by a ratio of approximately 2:1 and the rate of lower social class members over that of higher ones. We then turned to conclusions of our research for matters of primary and secondary prevention. Concerning primary prevention of psychogenic diseases life circumstances during childhood proved to be relevant as predisposing variables and risk factors often indicating poor emotional relationships between the child and its caretakers. Furthermore, we deal with protective factors preserving mental and physical health in spite of heavy burdens during childhood. Turning to secondary prevention we examine risk factors in present life, the importance of the lay system, and the influence of life events as well as the true demand for psychotherapy.
在讨论了关于神经症、性格障碍和身心障碍的流行病学研究的社会问题之后，我们概述了一项针对德国西部工业城市曼海姆600名具有代表性成年人的现场队列研究的主要结果。根据国际疾病分类第300 - 307类（世界卫生组织第8次修订版）以及基于症状严重程度的临床定量病例定义，我们发现总体病例率为26%，其中女性患病率高于男性，比例约为2:1，社会阶层较低者的患病率高于社会阶层较高者。然后我们转向研究对于一级和二级预防问题的结论。关于心因性疾病的一级预防，童年时期的生活环境被证明是相关的易患变量和风险因素，常常表明儿童与其照料者之间不良的情感关系。此外，我们探讨了尽管童年时期负担沉重但仍能保持身心健康的保护因素。转向二级预防，我们研究了当前生活中的风险因素、非专业系统的重要性、生活事件的影响以及心理治疗的实际需求。
