Jayasankar Pavithra, Satish Suhas, Suchandra Hari Hara, Manjunatha Narayana, Rao Girish N, Gururaj Gopalkrishna, Varghese Mathew, Benegal Vivek
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2023 Dec;65(12):1249-1253. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_825_23. Epub 2023 Dec 11.
Panic disorder (PD) is one of the most common and debilitating anxiety disorder. Individuals with PD seek frequent healthcare and emergency services leading to frequent work absenteeism and economic burden. However, its prevalence patterns in the Indian context are poorly understood. Hence, this article discusses the epidemiology, disability, and treatment gap from India's National Mental Health Survey 2016.
National Mental Health Survey 2016 was a nationally representative epidemiological survey of adult respondents from 12 states of India. Mini International Neuropsychiatric Interview 6.0.0 is used to diagnose psychiatric disorders. Sheehan disability scale was used to assess the disability. The current weighted prevalence of PD was estimated. Association between PD and its sociodemographic correlates was done using Firth penalized logistic regression. The treatment gap and disability in PD were also calculated.
The lifetime and current weighted prevalence of PD was 0.5% (95% confidence interval 0.49-0.52) and 0.3% (95% confidence interval 0.28-0.41), respectively. The male gender and unemployed have significantly lesser odds with current PD. The elderly, Urban metro, and the married/separated group have significantly higher odds with current PD. The most common comorbid psychiatric disorder is agoraphobia (42.3%) and depression (30.9%) followed by Generalized Anxiety Disorder (10%). Among respondents with current PD in the past 1 month across three domains, around 80% had a disability of any severity and 20%-25% had marked disability. The overall treatment gap of current PD is 71.7%.
It is the first study reporting prevalence from a nationally representative sample from the general population of India. The survey has shed light on the epidemiology and the challenges faced by those with PD which emphasizes the urgency of bridging the treatment gap. These findings are paramount to the development of more inclusive and effective mental health policies and interventions to tackle the current burden due to PD.
惊恐障碍(PD)是最常见且使人衰弱的焦虑症之一。患有惊恐障碍的个体频繁寻求医疗保健和急诊服务,导致频繁旷工和经济负担。然而,在印度背景下其流行模式却知之甚少。因此,本文讨论了来自2016年印度国家心理健康调查中的流行病学、残疾情况及治疗差距。
2016年国家心理健康调查是一项针对印度12个邦成年受访者的具有全国代表性的流行病学调查。使用迷你国际神经精神病学访谈6.0.0来诊断精神疾病。采用希恩残疾量表来评估残疾情况。估计了惊恐障碍的当前加权患病率。使用费思惩罚逻辑回归分析惊恐障碍与其社会人口学相关因素之间的关联。还计算了惊恐障碍的治疗差距和残疾情况。
惊恐障碍的终生加权患病率和当前加权患病率分别为0.5%(95%置信区间0.49 - 0.52)和0.3%(95%置信区间0.28 - 0.41)。男性和失业者患当前惊恐障碍的几率显著较低。老年人、城市地铁地区居民以及已婚/分居群体患当前惊恐障碍的几率显著较高。最常见的共病精神障碍是广场恐惧症(42.3%)和抑郁症(30.9%),其次是广泛性焦虑症(10%)。在过去1个月内患有当前惊恐障碍的受访者中,在三个领域中,约80%有任何严重程度的残疾,20% - 25%有明显残疾。当前惊恐障碍的总体治疗差距为71.7%。
这是第一项报告来自印度普通人群全国代表性样本患病率的研究。该调查揭示了惊恐障碍的流行病学以及患者所面临的挑战,强调了缩小治疗差距的紧迫性。这些发现对于制定更具包容性和有效的心理健康政策及干预措施以应对当前惊恐障碍造成的负担至关重要。