越南成年人常见和严重精神障碍的临床显著症状负担：一项基于人群的横断面调查。
The burden of clinically significant symptoms of common and severe mental disorders among adults in Vietnam: a population-based cross-sectional survey.
机构信息
School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
Research and Training Centre for Community Development (RTCCD), No 39, lane 255, Vong street, Hanoi, Vietnam.
出版信息
BMC Public Health. 2019 Aug 27;19(1):1173. doi: 10.1186/s12889-019-7513-7.
BACKGROUND
Vietnam has limited evidence about the burden of common and severe mental disorders among adults to inform policy. The aim of this paper was to estimate the prevalence of common and severe mental disorders among adults and factors associated with them in Vietnam.
METHODS
We conducted a cross-sectional household survey among people aged at least 16 years in Thanh Hoa and Ben Tre provinces which are nationally representative of the North and the South of Vietnam. The World Health Organization Self-Reporting Questionnaire 24 was used to screen for clinically significant symptoms of common and severe mental disorders at the individual level. Household characteristics were obtained in face-to-face interviews with the household heads. A multilevel mixed-effects logistic regression model was used to identify associated factors of the common and severe mental disorders.
RESULTS
Among 611 households which included 1528 adults, the point prevalence of clinically significant symptoms was 14.4% for common mental disorders and 8.2% for severe mental disorders after weighting by age groups. Common mental disorders were associated with social factors including lived in a Northern rather than a Southern province, disadvantaged household economic status, in which a family member(s) misused alcohol, the family lacking links to social organisations able to provide instrumental support, and the individual not having completed primary school. Severe mental disorders had fewer associations with social factors compared to common mental disorders, but were associated with living in the Northern province, disadvantaged household economic status, family violence and being older than 50 years.
CONCLUSIONS
The prevalence of clinically significant symptoms of common and severe mental disorders among adults in Vietnam was higher than in high income countries and had a strong association with household characteristics. The result indicates that a community-based approach to reduce household risk factors and to provide instrumental support might be an effective strategy to alleviate the burden of mental health problems in Vietnam.
背景
越南在成年人常见和严重精神障碍负担方面的证据有限，无法为政策提供信息。本文旨在评估越南成年人常见和严重精神障碍的患病率以及与之相关的因素。
方法
我们在 Thanh Hoa 和 Ben Tre 两省进行了一项横断面家庭调查，这两个省在全国范围内代表了越南的北部和南部。使用世界卫生组织自我报告问卷 24 对个体层面的常见和严重精神障碍进行临床显著症状筛查。家庭特征通过与家庭户主的面对面访谈获得。使用多水平混合效应逻辑回归模型来确定常见和严重精神障碍的相关因素。
结果
在包括 1528 名成年人的 611 个家庭中，经过年龄加权后，常见精神障碍的临床显著症状患病率为 14.4%，严重精神障碍的患病率为 8.2%。常见精神障碍与社会因素相关，包括居住在北部而不是南部省份、家庭经济地位不利、家庭成员滥用酒精、家庭与能够提供工具性支持的社会组织缺乏联系、以及个人未完成小学学业。与常见精神障碍相比，严重精神障碍与社会因素的关联较少，但与居住在北部省份、家庭经济地位不利、家庭暴力以及年龄大于 50 岁有关。
结论
越南成年人中常见和严重精神障碍的临床显著症状患病率高于高收入国家，与家庭特征密切相关。结果表明，以社区为基础的方法来减少家庭风险因素和提供工具性支持可能是减轻越南心理健康问题负担的有效策略。
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