Huang Yueqin, Wang Yu, Wang Hong, Liu Zhaorui, Yu Xin, Yan Jie, Yu Yaqin, Kou Changgui, Xu Xiufeng, Lu Jin, Wang Zhizhong, He Shulan, Xu Yifeng, He Yanling, Li Tao, Guo Wanjun, Tian Hongjun, Xu Guangming, Xu Xiangdong, Ma Yanjuan, Wang Linhong, Wang Limin, Yan Yongping, Wang Bo, Xiao Shuiyuan, Zhou Liang, Li Lingjiang, Tan Liwen, Zhang Tingting, Ma Chao, Li Qiang, Ding Hua, Geng Hongchun, Jia Fujun, Shi Jianfei, Wang Shiliang, Zhang Ning, Du Xinbai, Du Xiangdong, Wu Yue
Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Lancet Psychiatry. 2019 Mar;6(3):211-224. doi: 10.1016/S2215-0366(18)30511-X. Epub 2019 Feb 18.
The China Mental Health Survey was set up in 2012 to do a nationally representative survey with consistent methodology to investigate the prevalence of mental disorders and service use, and to analyse their social and psychological risk factors or correlates in China. This paper reports the prevalence findings.
We did a cross-sectional epidemiological survey of the prevalence of mental disorders (mood disorders, anxiety disorders, alcohol-use and drug-use disorders, schizophrenia and other psychotic disorders, eating disorder, impulse-control disorder, and dementia) in a multistage clustered-area probability sample of adults from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists with the Composite International Diagnostic Interview, the Structured Clinical Interview for DSM-IV Axis I disorders, the Community Screening Instrument for Dementia from the 10/66 dementia diagnostic package, and the Geriatric Mental State Examination. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted to adjust for differential probabilities of selection and differential response as well as to post-stratify the sample to match the population distribution.
32 552 respondents completed the survey between July 22, 2013, and March 5, 2015. The weighted prevalence of any disorder (excluding dementia) was 9·3% (95% CI 5·4-13·3) during the 12 months before the interview and 16·6% (13·0-20·2) during the participants' entire lifetime before the interview. Anxiety disorders were the most common class of disorders both in the 12 months before the interview (weighted prevalence 5·0%, 4·2-5·8) and in lifetime (7·6%, 6·3-8·8). The weighted prevalence of dementia in people aged 65 years or older was 5·6% (3·5-7·6).
The prevalence of most mental disorders in China in 2013 is higher than in 1982 (point prevalence 1·1% and lifetime prevalence 1·3%), 1993 (point prevalence 1·1% and lifetime prevalence 1·4%), and 2002 (12-month prevalence 7·0% and lifetime prevalence 13·2%), but lower than in 2009 (1-month prevalence 17·5%). The evidence from this survey poses serious challenges related to the high burdens of disease identified, but also offers valuable opportunities for policy makers and health-care professionals to explore and address the factors that affect mental health in China.
National Health Commission of Health (Ministry of Health) and Ministry of Science and Technology of China.
中国精神卫生调查于2012年启动，采用统一方法开展具有全国代表性的调查，以研究精神障碍的患病率及服务利用情况，并分析其在中国的社会和心理风险因素或相关因素。本文报告患病率调查结果。
我们对来自中国31个省份157个全国代表性的基于人群的疾病监测点的成年人进行了多阶段整群区域概率抽样，以开展精神障碍（情绪障碍、焦虑障碍、酒精使用和药物使用障碍、精神分裂症及其他精神病性障碍、进食障碍、冲动控制障碍和痴呆症）患病率的横断面流行病学调查。由经过培训的非专业访谈员和精神科医生采用两阶段设计，通过综合国际诊断访谈、DSM-IV轴I障碍的结构化临床访谈、10/66痴呆诊断包中的痴呆社区筛查工具以及老年精神状态检查进行面对面访谈。数据质量控制程序包括计算机逻辑检查、顺序记录检查、质量控制人员的电话核查以及精神科医生的再次访谈核查。对数据进行加权处理，以调整选择概率差异和应答差异，并对样本进行事后分层，使其与总体分布相匹配。
在2013年7月22日至2015年3月5日期间，32552名受访者完成了调查。在访谈前的12个月内，任何障碍（不包括痴呆症）的加权患病率为9.3%（95%CI 5.4-13.3），在受访者的整个生命期间为16.6%（13.0-20.2）。焦虑障碍在访谈前的12个月内（加权患病率5.0%，4.2-5.8）和一生中（7.6%，6.3-8.8）都是最常见的障碍类型。65岁及以上人群中痴呆症的加权患病率为5.6%（3.5-7.6）。
2013年中国大多数精神障碍的患病率高于1982年（时点患病率1.1%，终生患病率1.3%）、1993年（时点患病率1.1%，终生患病率1.4%）和2002年（12个月患病率7.0%，终生患病率13.2%），但低于2009年（1个月患病率17.5%）。本次调查的证据揭示了与所确定的高疾病负担相关的严峻挑战，但也为政策制定者和医疗保健专业人员提供了宝贵机会，以探索和解决影响中国心理健康的因素。
国家卫生健康委员会（原卫生部）和中国科学技术部。
