Rancans Elmars, Renemane Lubova, Kivite-Urtane Anda, Ziedonis Douglas
1Department of Psychiatry and Narcology, Riga Stradins University, 2 Tvaika Str, Riga, LV-1005 Latvia.
2Department of Public Health and Epidemiology, Riga Stradins University, 9 Kronvalda Ave, Riga, LV-1010 Latvia.
Ann Gen Psychiatry. 2020 Apr 7;19:25. doi: 10.1186/s12991-020-00276-5. eCollection 2020.
Mental disorders are common amongst patients in primary care. There are no published studies on the prevalence of mental disorders in primary care patients in Latvia. The purpose of the study was to evaluate the current prevalence of mental disorders in the nationwide Latvian primary care population and to study possible associated factors and comorbidity of mental disorders.
A cross-sectional study within the framework of the National Research Program BIOMEDICINE 2014-2017 was performed at 24 primary care settings across Latvia. Adult patients seen over a 1-week time period at each facility were invited to participate in the study. Sociodemographic variables (age, sex, education, employment and marital status, place of residence, and ethnicity) were assessed onsite. A Mini-International Neuropsychiatric Interview assessment was conducted over the telephone within 2 weeks after the visit to the general practitioner (GP).
Overall, 1485 individuals completed the interview. The current prevalence of any mental disorder was 37.2% and was significantly greater in women. Mood disorders (18.4%), suicidality (18.6%) and anxiety disorders (15.8%) were the most frequent diagnostic categories. The current prevalence of any mood disorder was associated with being 50-64 years of age, female sex, economically inactive status, divorced or widowed marital status and urban place of residence, whilst any current anxiety disorder was associated with female sex, lower education, and single marital status; however, being of Russian ethnicity and residing in a small city were protective factors. Suicidality was associated with female sex, lower education, unemployment or economically inactive status, being divorced or widowed and residing in a small city. The comorbidity rates between mental disorders varied from 2.9 to 53.3%.
High prevalence rates of mental disorders, comorbidity and certain associated socio-demographic factors were found in primary care settings in Latvia. This highlights the importance of screening for depression and anxiety disorders and suicidal risk assessment by GPs. The results are fundamentally important for integrative medicine, monitoring and promotion of mental healthcare at the primary care level, as well as for healthcare policy and development of strategic plans in Latvia.
精神障碍在初级保健患者中很常见。拉脱维亚尚未发表关于初级保健患者精神障碍患病率的研究。本研究的目的是评估拉脱维亚全国初级保健人群中精神障碍的当前患病率，并研究精神障碍可能的相关因素和共病情况。
在2014 - 2017年国家研究计划“生物医学”框架内进行了一项横断面研究，研究对象为拉脱维亚全国24个初级保健机构。邀请在每个机构1周内就诊的成年患者参与研究。现场评估社会人口统计学变量（年龄、性别、教育程度、就业和婚姻状况、居住地点和种族）。在患者拜访全科医生（GP）后2周内通过电话进行简易国际神经精神访谈评估。
总体而言，1485人完成了访谈。任何精神障碍的当前患病率为37.2%，女性患病率显著更高。情绪障碍（18.4%）、自杀倾向（18.6%）和焦虑障碍（15.8%）是最常见的诊断类别。任何情绪障碍的当前患病率与年龄在50 - 64岁、女性、经济不活跃状态、离婚或丧偶婚姻状况以及城市居住地点相关，而任何当前焦虑障碍与女性、低教育程度和单身婚姻状况相关；然而，俄罗斯族裔和居住在小城市是保护因素。自杀倾向与女性、低教育程度、失业或经济不活跃状态、离婚或丧偶以及居住在小城市相关。精神障碍之间的共病率在2.9%至53.3%之间。
在拉脱维亚的初级保健机构中发现了精神障碍、共病以及某些相关社会人口统计学因素的高患病率。这凸显了全科医生筛查抑郁和焦虑障碍以及进行自杀风险评估的重要性。这些结果对于综合医学、在初级保健层面监测和促进精神卫生保健以及拉脱维亚的卫生保健政策和战略计划的制定具有根本重要性。
