Subramaniam Mythily, Abdin Edimansyah, Vaingankar Janhavi A, Sambasivam Rajeswari, Zhang Yun Jue, Shafie Saleha, Basu Sutapa, Chan Chun Ting, Tan Chuen Seng, Verma Swapna K, Tang Charmaine, Chua Hong Choon, Heng Derrick, Chong Siow Ann
Research Division, Institute of Mental Health, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Front Psychiatry. 2021 Mar 11;12:650674. doi: 10.3389/fpsyt.2021.650674. eCollection 2021.
The current study aimed to establish the lifetime prevalence of schizophrenia and other psychotic disorders, its sociodemographic correlates and association with physical disorders using data from the Singapore Mental Health Study (SMHS 2016). A two-phase design comprising population-level screening of psychotic symptoms using the World Health Organization Composite International Diagnostic Interview version 3.0 psychosis screen followed by clinical reappraisal based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria were used to establish the prevalence. A total of 6,126 respondents completed the first phase of the study, giving a response rate of 69.5%. 5.2% ( = 326) of respondents endorsed at least one symptom in the psychosis screen. After the phase two clinical reappraisal interviews and adjusting for false-negative rate, the corrected prevalence of schizophrenia and other psychotic disorders was 2.3% (95% CI: 2.3-2.3%). The odds of having DSM-IV schizophrenia and other psychotic disorders was significantly higher among those of Malay ethnicity (OR = 3.9, 95% CI 1.4-11.0), and those who were unemployed (OR = 4.3, 95% CI 1.2-15.9). 80.4% of those with a psychotic disorder had consulted a doctor or a mental health professional for their symptoms. Our results indicate that approximately 2.3% of Singapore's community-dwelling adult population had a lifetime diagnosis of schizophrenia and other psychotic disorders. While the treatment gap of the disorder was relatively small, the severe nature of the disorder emphasizes the need for continued outreach and early diagnosis and treatment.
本研究旨在利用新加坡精神健康研究(SMHS 2016)的数据,确定精神分裂症和其他精神病性障碍的终生患病率、其社会人口学相关因素以及与躯体疾病的关联。采用两阶段设计,首先使用世界卫生组织复合国际诊断访谈第3.0版精神病筛查对精神病性症状进行人群水平筛查,然后根据《精神障碍诊断与统计手册》第四版(DSM-IV)标准进行临床重新评估,以确定患病率。共有6126名受访者完成了研究的第一阶段,应答率为69.5%。5.2%(=326)的受访者在精神病筛查中认可至少一种症状。经过第二阶段的临床重新评估访谈并校正假阴性率后,精神分裂症和其他精神病性障碍的校正患病率为2.3%(95%CI:2.3 - 2.3%)。马来族裔人群患DSM-IV精神分裂症和其他精神病性障碍的几率显著更高(OR = 3.9,95%CI 1.4 - 11.0),以及失业者(OR = 4.3,95%CI 1.2 - 15.9)。80.4%的患有精神病性障碍的人曾就其症状咨询过医生或心理健康专业人员。我们的结果表明,新加坡社区居住的成年人口中约2.3%曾被诊断患有精神分裂症和其他精神病性障碍。虽然该疾病的治疗差距相对较小,但该疾病的严重性强调了持续开展外展服务以及早期诊断和治疗的必要性。