Department of Preventive and Social Medicine, University of Medicine, Yangon, Myanmar.
Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
BMC Public Health. 2020 Jan 22;20(1):94. doi: 10.1186/s12889-020-8209-8.
Poor mental health is an important contributor to the global burden of disease. Mental health problems are often neglected in communities, and are scarcely studied in developing countries, including Myanmar. This study estimates the prevalence of mental distress by socio-demographic and health related factors, and the association between education and mental distress. As far as the authors are aware, this is the first population-based study in Myanmar estimating the prevalence of mental distress.
Between October and November 2016, a cross sectional study was conducted using a multi-stage sampling design with face-to-face interviews using the Hopkins Symptom Checklist (HSCL-10) for mental distress (symptoms of depression and anxiety). The multivariable analysis strategy was based on Directed Acyclic Graphs (DAGs), to identify confounders, mediators and colliders. Pearson's chi-square was used for testing differences between proportions and multiple linear regression analysis was applied to explore the association between education (years at school) and mental distress (HSCL score).
A random sample of 2391 (99.6% response) men and women aged 18-49 years participated in the study. The prevalence of mental distress was 18.0% (95% confidence interval (CI): 14.7-21.9), being higher among women (21.2%; 95% (CI): 16.6-26.6) than men (14.9%; 95% (CI): 11.4-19.2). Older-age, being separated or divorced and having a higher number of children were associated with increased mental distress. In linear regression analyses, adjusted for confounders (age, marital status and income), there was a significant negative association between years at school and mental distress among women and older men (> 30 years), but not among the youngest men.
The prevalence of mental distress is high, and there is an association between HSCL-10 score and education. Due to the scarcity of mental health services in Myanmar, the findings indicate a need for a mental health policy to handle the burden of mental health problems in Yangon, a burden which is probably high within the country.
心理健康状况不佳是全球疾病负担的一个重要因素。心理健康问题在社区中经常被忽视，在包括缅甸在内的发展中国家也很少得到研究。本研究根据社会人口学和健康相关因素来估计精神困扰的流行率，并研究教育与精神困扰之间的关系。据作者所知，这是缅甸首次进行的一项基于人群的研究，旨在估计精神困扰的流行率。
2016 年 10 月至 11 月期间，采用多阶段抽样设计进行了一项横断面研究，采用面对面访谈的方式，使用 Hopkins 症状清单（HSCL-10）评估精神困扰（抑郁和焦虑症状）。多变量分析策略基于有向无环图（DAG），以确定混杂因素、中介因素和共发因素。采用 Pearson's 卡方检验比较比例差异，采用多元线性回归分析探索教育（在校年限）与精神困扰（HSCL 评分）之间的关系。
随机抽取了 2391 名 18-49 岁的男性和女性参与研究，应答率为 99.6%。精神困扰的患病率为 18.0%（95%置信区间：14.7-21.9%），女性（21.2%；95%置信区间：16.6-26.6%）高于男性（14.9%；95%置信区间：11.4-19.2%）。年龄较大、离异或分居以及子女较多与精神困扰增加有关。在校年限与女性和年龄较大的男性（>30 岁）的精神困扰呈显著负相关，但在校年限与最年轻的男性无关，这在调整了混杂因素（年龄、婚姻状况和收入）的线性回归分析中得到了验证。
精神困扰的患病率较高，HSCL-10 评分与教育之间存在关联。由于缅甸的精神卫生服务稀缺，研究结果表明需要制定一项精神卫生政策来应对仰光的精神卫生问题负担，而该负担在该国可能很高。
