Institute of Population Research, Peking University, Beijing, China.
APEC Health Science Academy (HeSAY), Peking University, Beijing, China.
J Intellect Disabil Res. 2018 Feb;62(2):106-114. doi: 10.1111/jir.12451. Epub 2017 Nov 26.
Adults with intellectual disabilities (ID) often have multiple comorbidities. Psychiatric disorders in this population have been poorly studied in developing countries. We aimed to investigate the prevalence of psychiatric disorders in adults with ID and whether comorbid psychiatric disorders were associated with health service utilisation.
We obtained data from the Second National Sample Survey on Disability, conducted in 31 provinces of China and selected a subsample of 13 631 adults aged 18 years and above with ID. ID were defined by intelligence quotient score under 70, deficits in two or more adaptive behaviours and age of onset under 18 years. Psychiatric disorders were identified according to the International Statistical Classification of Diseases, Tenth Revision. Logistic regressions were used for data analyses.
The prevalence of psychiatric disorders in adults with ID was 16.7%. The most prevalent type of psychiatric disorder was dementia. Older adults, females, being minorities, urban residents, being literate, low-income groups and having severe ID, were associated with elevated risk of psychiatric disorder among adults with ID. Compared with individuals without psychiatric disorders, those with comorbid psychiatric disorders were more likely to use medical service and less likely to use rehabilitation service.
The prevalence of psychiatric disorder in adults with ID was strikingly higher than that in the general population. Health service utilisation among Chinese adults with ID remained a big challenge. There is a possibility of diagnostic overshadowing by local clinicians, which may have resulted in overdiagnosis of dementia and underdiagnosis of common mental disorders. This study informs further investigations regarding common mental disorders among people with ID and has implications for public health strategies and health policies to meet health service need for this population.
成年智障人士（ID）通常患有多种合并症。发展中国家对该人群的精神疾病研究甚少。我们旨在调查智障成年人中精神疾病的患病率，以及合并的精神疾病是否与卫生服务利用有关。
我们从中国 31 个省进行的第二次全国残疾人抽样调查中获取数据，并选择了 13631 名 18 岁及以上的智障成年人作为亚样本。智障是根据智商得分低于 70、两种或多种适应行为缺陷以及发病年龄在 18 岁以下来定义的。精神疾病是根据《国际疾病分类，第十版》来确定的。我们使用逻辑回归进行数据分析。
智障成年人中精神疾病的患病率为 16.7%。最常见的精神疾病类型是痴呆症。年龄较大、女性、少数民族、城市居民、识字、低收入群体和严重智障与智障成年人精神疾病风险升高有关。与无精神疾病的个体相比，合并精神疾病的个体更有可能使用医疗服务，而不太可能使用康复服务。
智障成年人中精神疾病的患病率明显高于一般人群。中国智障成年人的卫生服务利用仍然是一个巨大的挑战。当地临床医生可能存在诊断掩盖现象，这可能导致痴呆症的过度诊断和常见精神障碍的漏诊。本研究为智障人群的常见精神障碍进一步调查提供了信息，并对公共卫生策略和卫生政策具有重要意义，以满足该人群的卫生服务需求。
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