Kovalchuk Yevgeniya, Stewart Robert, Broadbent Matthew, Hubbard Tim J P, Dobson Richard J B
School of Computing and Digital Technology, Faculty of Computing, Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom.
Department of Psychological Medicine, The Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
PLoS One. 2017 Feb 16;12(2):e0171526. doi: 10.1371/journal.pone.0171526. eCollection 2017.
The UK government has recently recognised the need to improve mental health services in the country. Electronic health records provide a rich source of patient data which could help policymakers to better understand needs of the service users. The main objective of this study is to unveil statistics of diagnoses recorded in the Case Register of the South London and Maudsley NHS Foundation Trust, one of the largest mental health providers in the UK and Europe serving a source population of over 1.2 million people residing in south London. Based on over 500,000 diagnoses recorded in ICD10 codes for a cohort of approximately 200,000 mental health patients, we established frequency rate of each diagnosis (the ratio of the number of patients for whom a diagnosis has ever been recorded to the number of patients in the entire population who have made contact with mental disorders). We also investigated differences in diagnoses prevalence between subgroups of patients stratified by gender and ethnicity. The most common diagnoses in the considered population were (recurrent) depression (ICD10 codes F32-33; 16.4% of patients), reaction to severe stress and adjustment disorders (F43; 7.1%), mental/behavioural disorders due to use of alcohol (F10; 6.9%), and schizophrenia (F20; 5.6%). We also found many diagnoses which were more likely to be recorded in patients of a certain gender or ethnicity. For example, mood (affective) disorders (F31-F39); neurotic, stress-related and somatoform disorders (F40-F48, except F42); and eating disorders (F50) were more likely to be found in records of female patients, while males were more likely to be diagnosed with mental/behavioural disorders due to psychoactive substance use (F10-F19). Furthermore, mental/behavioural disorders due to use of alcohol and opioids were more likely to be recorded in patients of white ethnicity, and disorders due to use of cannabinoids in those of black ethnicity.
英国政府最近认识到有必要改善该国的心理健康服务。电子健康记录提供了丰富的患者数据来源，这有助于政策制定者更好地了解服务使用者的需求。本研究的主要目的是揭示在南伦敦和莫兹利国民保健服务基金会信托基金病例登记册中记录的诊断统计数据，该信托基金是英国和欧洲最大的心理健康服务提供者之一，服务对象是居住在伦敦南部的120多万人。基于为大约20万名心理健康患者记录的50多万个国际疾病分类第10版（ICD10）编码诊断，我们确定了每种诊断的发生率（有诊断记录的患者数量与所有接触过精神障碍的患者数量之比）。我们还调查了按性别和种族分层的患者亚组之间诊断患病率的差异。在所研究的人群中，最常见的诊断是（复发性）抑郁症（ICD10编码F32 - 33；占患者的16.4%）、对严重应激的反应和适应障碍（F43；7.1%）、因使用酒精导致的精神/行为障碍（F10；6.9%）以及精神分裂症（F20；5.6%）。我们还发现许多诊断在特定性别或种族的患者中更有可能被记录。例如，心境（情感）障碍（F31 - F39）；神经症、应激相关和躯体形式障碍（F40 - F48，F42除外）；以及进食障碍（F50）在女性患者记录中更常见，而男性更有可能被诊断为因使用精神活性物质导致的精神/行为障碍（F10 - F19）。此外，因使用酒精和阿片类药物导致的精神/行为障碍在白人种族患者中更有可能被记录，而因使用大麻素导致的障碍在黑人种族患者中更常见。
