Departments of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America.
Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Kenya.
Compr Psychiatry. 2024 May;131:152473. doi: 10.1016/j.comppsych.2024.152473. Epub 2024 Mar 11.
There are few psychiatric epidemiology studies among Kenyan youth and fewer among those at high psychosis risk (HR).
This study assessed the epidemiology of DSM-5 psychiatric disorders in HR and low-risk (LR) individuals to inform research and mental health services. 567 participants (aged 15-25) in HR (n = 246) and LR (n = 260) groups based on Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen scores. Diagnostic Interview Schedule, version 5 (DIS-5) assessed DSM-5 psychiatric disorder prevalence. Diagnostic comorbidity and demographic relationships were investigated.
A higher prevalence was observed for all DSM-5 disorders in the HR group, significantly for gambling disorder (13% vs. 5.8%), major depressive disorder (9.8% vs. 3.8%), antisocial personality disorder (5.7% vs. 2.3%), general anxiety disorder (4.9% vs. 0.4%), oppositional defiant disorder (3.3% vs. 0.4%), panic disorder (2.8% vs. 0.8%), and anorexia nervosa (2.8% vs. 0%). Gambling disorder was the most prevalent and showed significant gender effects (males>females).
Psychiatric disorders occur at increased rates among HR compared to LR. Prevalence rates found are lower than in US studies, except for gambling disorder which was highly prevalent. Large-population-based epidemiology studies in Africa are needed to estimate rates, particularly of disorders such as schizophrenia, accurately.
肯尼亚青年人群中很少有精神病学流行病学研究，而高危（HR）人群中则更少。
本研究评估了 HR 和低危（LR）个体中 DSM-5 精神障碍的流行病学情况，为研究和精神卫生服务提供信息。根据华盛顿早期识别中心情感和精神病（WERCAP）筛查评分，对 567 名 HR（n=246）和 LR（n=260）组的 15-25 岁参与者进行研究。使用诊断访谈表第五版（DIS-5）评估 DSM-5 精神障碍的患病率。研究了诊断共病和人口统计学关系。
HR 组所有 DSM-5 障碍的患病率均较高，其中赌博障碍（13% vs. 5.8%）、重度抑郁症（9.8% vs. 3.8%）、反社会人格障碍（5.7% vs. 2.3%）、广泛性焦虑障碍（4.9% vs. 0.4%）、对立违抗性障碍（3.3% vs. 0.4%）、惊恐障碍（2.8% vs. 0.8%）和神经性厌食症（2.8% vs. 0%）更为显著。赌博障碍最为普遍，且存在显著的性别差异（男性>女性）。
与 LR 相比，HR 人群中精神障碍的发生率更高。除赌博障碍外，本研究发现的患病率低于美国研究，而赌博障碍的患病率非常高。需要在非洲开展大规模的基于人群的流行病学研究，以准确评估精神分裂症等疾病的发病率。
