Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
J Child Psychol Psychiatry. 2022 Jan;63(1):34-46. doi: 10.1111/jcpp.13445. Epub 2021 May 21.
To date, no national-scale psychiatric epidemiological survey for children and adolescents has been conducted in China. In order to inform government officials and policymakers and to develop a comprehensive plan for service providers, there was a clear need to conduct an up-to-date systematic nationwide psychiatric epidemiological survey.
We conducted a two-stage large-scale psychiatric point prevalence survey. Multistage cluster stratified random sampling was used as the sampling strategy. Five provinces were selected by comprehensively considering geographical partition, economic development, and rural/urban factors. In Stage 1, the Child Behavior Checklist was used as the screening tool. In Stage 2, Mini-International Neuropsychiatric Interview for Children and Adolescents and a diagnostic process based on the Diagnostic and Statistical Manual were used to make the diagnoses. Sampling weights and poststratification weights were employed to match the population distributions. Exploratory analyses were also performed using socio-demographic factors. Prevalence in socio-demographic factor subgroups and overall were estimated. Rao-Scott adjusted chi-square tests were utilized to determine if between-group differences were present. Factor interactions were checked by logistic regression analyses.
A total of 73,992 participants aged 6-16 years of age were selected in Stage 1. In Stage 2, 17,524 individuals were screened and diagnosed. The weighted prevalence of any disorder was 17.5% (95% CI: 17.2-18.0). Statistically significant differences in prevalence of any psychiatric disorder were observed between sexes [χ (1, N = 71,929) = 223.0, p < .001], age groups [χ (1, N = 71,929) = 18.6, p < .001] and developed vs. developing areas [χ (1, N = 71,929) = 2,129.6, p < .001], while no difference was found between rural and urban areas [χ (1, N = 71,929) = 1.4, p = .239]. Male, younger individuals, children, and adolescents from developed areas had higher prevalence of any psychiatric disorder. The prevalence of any psychiatric disorder was found to decrease with the age in the male group, while the female group increased with the age. Individuals diagnosed with attention-deficit hyperactivity disorder, oppositional defiant disorder, a tic disorder, conduct disorder, and major depression disorder had the highest rates of comorbidity.
The prevalence of any psychiatric disorder we found is the highest ever reported in China. These results urgently need to be addressed by public mental health service providers and policymakers in order to provide access to the necessary treatments and to reduce the long-term negative impact of these conditions on families and the society as a whole.
迄今为止，中国尚未开展过全国性的儿童和青少年精神流行病学调查。为了为政府官员和政策制定者提供信息，并为服务提供者制定全面的计划，显然需要进行最新的全国性精神流行病学系统调查。
我们进行了两阶段的大规模精神点患病率调查。多阶段聚类分层随机抽样被用作抽样策略。通过综合考虑地理分区、经济发展和城乡因素，选择了五个省份。在第 1 阶段，使用儿童行为检查表作为筛选工具。在第 2 阶段，使用儿童和青少年的 Mini-国际神经精神访谈和基于诊断与统计手册的诊断程序进行诊断。采用抽样权重和后分层权重来匹配人口分布。还使用社会人口统计学因素进行了探索性分析。估计了社会人口统计学因素亚组和总体的患病率。采用 Rao-Scott 调整卡方检验确定组间是否存在差异。通过逻辑回归分析检查因素相互作用。
在第 1 阶段共选择了 6-16 岁的 73992 名参与者。在第 2 阶段，筛选和诊断了 17524 人。任何障碍的加权患病率为 17.5%（95%CI：17.2-18.0）。在任何精神障碍的患病率方面，性别[χ（1，N=71929）=223.0，p<0.001]、年龄组[χ（1，N=71929）=18.6，p<0.001]和发达地区与发展中地区[χ（1，N=71929）=2129.6，p<0.001]之间存在统计学显著差异，而城乡之间无差异[χ（1，N=71929）=1.4，p=0.239]。男性、年龄较小的个体、儿童和青少年来自发达地区，其任何精神障碍的患病率较高。在男性组中，任何精神障碍的患病率随年龄增长而降低，而在女性组中则随年龄增长而增加。被诊断患有注意缺陷多动障碍、对立违抗性障碍、抽动障碍、品行障碍和重度抑郁症的个体的合并症发生率最高。
我们发现的任何精神障碍的患病率是中国有史以来报告的最高水平。公共精神卫生服务提供者和政策制定者急需解决这些结果，以便为这些疾病的患者提供必要的治疗，并减少这些疾病对家庭和整个社会的长期负面影响。
