Policy and Epidemiology Group,Queensland Centre for Mental Health Research,Brisbane,Australia.
BasicNeeds,158A Parade,Leamington Spa,Warwickshire CV32 4AE,UK.
Epidemiol Psychiatr Sci. 2019 Feb;28(1):54-65. doi: 10.1017/S204579601700035X. Epub 2017 Jul 24.
An epidemiological survey was conducted to determine the prevalence of the mental and substance use disorders and ascertain patterns of mental health services utilisation in Lao People's Democratic Republic (Lao PDR) with the aim of evaluating existing gaps and opportunities in the provision of mental health services.
This study was a cross-sectional, household survey of adults living within Vientiane Capital province, Lao PDR. We collected data on participant demographics, mental and physical health status, family history of mental illness and exposure to potential risk factors. It also collected data on mental health service utilisation patterns, types of health professionals and treatment being accessed, barriers to treatment and perceived need for care. The MINI International Neuropsychiatric Interview (MINI v.6.0) was also administered to assess mental disorder prevalence.
Age- and sex-standardised current prevalence of any disorder was estimated at 15.2% (95% CI 11.0-20.7). Alcohol dependence (5.5% (95% CI 3.2-9.6)), was the most prevalent followed by anxiety disorders (5.2% (95% CI 3.2-8.3)) and mood disorders (2.5% (95% CI 1.5-4.4)). 11.0% (95% CI 5.8-20.1) of participants with a mental and/or substance use disorder suffered from other comorbid disorders. A number of variables demonstrated significant effects in final logistic regression models, including family history, education and employment for mental disorders; and gender, numbers of hours worked per week and number of dependants for substance use disorders. Having a mental or substance use disorder was associated with an OR of 11.6 of suicidality over participants without a mental or substance use disorder (95% CI 2.8-58.5). Of the 101 participants who met criteria for a current mental or substance use disorder, only two (2.1% (95% CI 0.5-8.0)) had accessed services for their mental health in the past 12 months. No participants who had seen a health professional in the past 12 months reported getting as much help as they needed. The vast majority (89.2% (95% CI 76.5-95.4)) of participants meeting criteria for a current mental or substance use disorder reported that they had not experienced mental health problems in the past 12 months.
This study presents the first epidemiological estimates for a range of mental and substance use disorders in the general population of the most populous province in Lao PDR. A large treatment gap exists for mental and substance use disorders in Lao PDR. This research adds value for health care and has been an important precursor to developing informed and targeted mental health policy, services and health system reform in Lao PDR.
本研究旨在通过对老挝人民民主共和国（老挝）成年人进行横断面家庭调查，以确定精神和物质使用障碍的流行情况，并确定精神卫生服务利用模式，从而评估老挝精神卫生服务提供方面存在的差距和机会。
这是一项对老挝万象省成年人的横断面、家庭调查。我们收集了参与者的人口统计学、精神和身体健康状况、精神疾病家族史和潜在风险因素暴露情况的数据。它还收集了精神卫生服务利用模式、所接受的卫生专业人员和治疗类型、治疗障碍和感知到的护理需求的数据。还使用 MINI 国际神经精神访谈 (MINI v.6.0) 评估了精神障碍的患病率。
年龄和性别标准化的当前任何障碍患病率估计为 15.2%（95%CI 11.0-20.7）。酒精依赖症（5.5%（95%CI 3.2-9.6））是最常见的，其次是焦虑症（5.2%（95%CI 3.2-8.3））和心境障碍（2.5%（95%CI 1.5-4.4））。11.0%（95%CI 5.8-20.1）的有精神和/或物质使用障碍的参与者患有其他共病障碍。一些变量在最终的逻辑回归模型中表现出显著影响，包括精神障碍的家族史、教育和就业；以及物质使用障碍的性别、每周工作小时数和受抚养人数。有精神或物质使用障碍的参与者自杀的可能性是没有精神或物质使用障碍的参与者的 11.6 倍（95%CI 2.8-58.5）。在 101 名符合当前精神或物质使用障碍标准的参与者中，只有两名（2.1%（95%CI 0.5-8.0））在过去 12 个月中接受过心理健康服务。在过去 12 个月中看过卫生专业人员的参与者中，没有报告得到了他们所需的帮助。绝大多数（89.2%（95%CI 76.5-95.4））符合当前精神或物质使用障碍标准的参与者报告在过去 12 个月中没有经历过心理健康问题。
本研究首次在老挝人口最多的省份的一般人群中对一系列精神和物质使用障碍进行了流行病学估计。老挝在精神和物质使用障碍方面存在巨大的治疗差距。这项研究为医疗保健提供了价值，并为老挝制定知情和有针对性的精神卫生政策、服务和卫生系统改革奠定了重要基础。
