Qian Jie, Zhang Hanzhi, Guo Aizhen, Fu Qiangqiang, Shi Jianwei, Jin Hua, Yu Dehua
Department of Clinical Psychology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China.
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
BMC Psychiatry. 2025 Mar 10;25(1):216. doi: 10.1186/s12888-025-06656-z.
The prevalence of mental disorders is gradually increasing in China. As the Chinese government fully implements the tiered diagnosis and treatment system, community health service centers will take on an increased role in the diagnosis and treatment of mental disorders. However, Chinese general practitioners currently have limited expertise in mental health. The health administration is still exploring which areas should be the focus of training for general practitioners in their capability to handle mental disorders.
To understand the types and characteristics of mental disorders, which can provide direction and evidence for improving the diagnosis and treatment capabilities of mental disorders in community mental health services in China.
The data of outpatient visits of all community health service centers in Shanghai were extracted from the outpatient and emergency information system platform of primary care institutions during 2014 to 2020. All of the diagnoses of mental disorders were classified and counted according to the ICD-10 code. Mental disorders were analyzed by the specific types, gender, age group and regions.
From 2014 to 2022, the proportion of patients with mental disorders in community health. Service centers in Shanghai has been increasing year by year, from 0.8% to 2.8%. The most common diagnostic category was F40-48: "Neurotic, stress-related and somatoform disorders", accounting for 50.9% of all mental disorders. Neurotic disorders, Non-organic sleep disorders and depressive episodes were the top three mental disorders. In the children and adolescents group aged 0-18 years, the most common diagnosis category was F80-F89: "Disorders of psychological development", accounting for 68.6% of the total number of children and adolescents with mental disorders in community health service centers. In the adult group, the Nonorganic sleep disorders and dementia gradually increased with age, while neurotic disorders and depressive episodes decreased after peaking at age the group 60 to 79.
In China, an increasing number of patients with mental disorders are seeking medical attention at community health service centers, while the knowledge and skills of general practitioners on mental disorders were still insufficient. Neurotic disorders, insomnia, depression as well as Disorders of psychological development in children and adolescents need to be studied more and paid attention to by general practitioners.
中国精神障碍的患病率正在逐渐上升。随着中国政府全面实施分级诊疗制度，社区卫生服务中心在精神障碍的诊断和治疗中将发挥更大作用。然而，中国全科医生目前在心理健康方面的专业知识有限。卫生行政部门仍在探索哪些领域应成为全科医生处理精神障碍能力培训的重点。
了解精神障碍的类型和特征，为提高中国社区精神卫生服务中精神障碍的诊断和治疗能力提供方向和依据。
从上海市所有社区卫生服务中心2014年至2020年的门诊和急诊信息系统平台中提取门诊就诊数据。所有精神障碍诊断均根据国际疾病分类第十版（ICD - 10）编码进行分类和计数。按具体类型、性别、年龄组和地区对精神障碍进行分析。
2014年至2022年，上海市社区卫生服务中心精神障碍患者的比例逐年上升，从0.8%升至2.8%。最常见的诊断类别是F40 - 48：“神经症性、应激相关及躯体形式障碍”，占所有精神障碍的50.9%。神经症性障碍、非器质性睡眠障碍和抑郁发作是前三大精神障碍。在0 - 18岁儿童青少年组中，最常见的诊断类别是F80 - F89：“心理发育障碍”，占社区卫生服务中心儿童青少年精神障碍总数的68.6%。在成人组中，非器质性睡眠障碍和痴呆随年龄逐渐增加，而神经症性障碍和抑郁发作在60至79岁年龄组达到峰值后下降。
在中国，越来越多的精神障碍患者在社区卫生服务中心寻求医疗服务，而全科医生对精神障碍的知识和技能仍不足。神经症性障碍、失眠、抑郁症以及儿童青少年心理发育障碍需要全科医生更多地研究和关注。
