肯尼亚西部社区样本中精神疾病的患病率。
PREVALENCE of psychiatric morbidity in a community sample in Western Kenya.
作者信息
Kwobah Edith, Epstein Steve, Mwangi Ann, Litzelman Debra, Atwoli Lukoye
机构信息
Department of Mental Health, Moi University School of Medicine and Moi Teaching and Referral Hospital, PO Box 3, 30100, Eldoret, Kenya.
Department of Psychiatry, Georgetown University, 3800 reservoir Rd NW, Washington, DC, 20007, USA.
出版信息
BMC Psychiatry. 2017 Jan 18;17(1):30. doi: 10.1186/s12888-017-1202-9.
BACKGROUND
About 25% of the worldwide population suffers from mental, neurological and substance use disorders but unfortunately, up to 75% of affected persons do not have access to the treatment they need. Data on the magnitude of the mental health problem in Kenya is scarce. The objectives of this study were to establish the prevalence and the socio-demographic factors associated with mental and substance use disorders in Kosirai division, Nandi County, Western Kenya.
METHODS
This was a cross sectional descriptive study in which participants were selected by simple random sampling. The sampling frame was obtained from a data base of the population in the study area developed during door-to-door testing and counseling exercises for HIV/AIDS. Four hundred and twenty consenting adults were interviewed by psychologists using the Mini International Neuropsychiatric Interview Version 7 for Diagnostic and Statistical Manual 5th Edition and a researcher-designed social demographic questionnaire.
RESULTS
One hundred and ninety one (45%) of the participants had a lifetime diagnosis of at least one of the mental disorders. Of these, 66 (15.7%) had anxiety disorder, 53 (12.3%) had major depressive disorder; 49 (11.7%) had alcohol and substance use disorder. 32 (7.6%) had experienced a psychotic episode and 69 (16.4%) had a life-time suicidal attempt. Only 7 (1.7%) had ever been diagnosed with a mental illness. Having a mental condition was associated with age less than 60 years and having a medical condition.
CONCLUSION
A large proportion of the community has had a mental disorder in their lifetime and most of these conditions are undiagnosed and therefore not treated. These findings indicate a need for strategies that will promote diagnosis and treatment of community members with psychiatric disorders. In order to screen more people for mental illness, we recommend further research to evaluate a strategy similar to the home based counseling and testing for HIV and the use of simple screening tools.
背景
全球约25%的人口患有精神、神经和物质使用障碍，但不幸的是，高达75%的患者无法获得所需的治疗。肯尼亚心理健康问题严重程度的数据匮乏。本研究的目的是确定肯尼亚西部南迪县科西莱分区精神和物质使用障碍的患病率以及与之相关的社会人口学因素。
方法
这是一项横断面描述性研究，通过简单随机抽样选择参与者。抽样框架来自于在针对艾滋病毒/艾滋病的挨家挨户检测和咨询活动期间建立的研究区域人口数据库。420名同意参与的成年人由心理学家使用《精神疾病诊断与统计手册》第5版的迷你国际神经精神病学访谈第7版以及一份由研究人员设计的社会人口学问卷进行访谈。
结果
191名（45%）参与者曾被诊断患有至少一种精神障碍。其中，66名（15.7%）患有焦虑症，53名（12.3%）患有重度抑郁症；49名（11.7%）患有酒精和物质使用障碍。32名（7.6%）经历过精神病发作，69名（16.4%）有过终身自杀未遂经历。只有7名（1.7%）曾被诊断患有精神疾病。患有精神疾病与年龄小于60岁以及患有躯体疾病有关。
结论
很大一部分社区居民一生中曾患有精神障碍，且这些疾病大多未被诊断，因此未得到治疗。这些发现表明需要制定策略来促进对患有精神疾病的社区成员的诊断和治疗。为了筛查更多的精神疾病患者，我们建议进一步开展研究，以评估一种类似于基于家庭的艾滋病毒咨询和检测的策略以及使用简单的筛查工具。
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