Sartorius N, Ustün T B, Lecrubier Y, Wittchen H U
Department of Psychiatry, University of Geneva, Switzerland.
Br J Psychiatry Suppl. 1996 Jun(30):38-43.
The World Health Organization collaborative study on "Psychological Problems in General Health Care" investigated the form, frequency, course and outcome of common psychological problems in primary care settings at 15 international sites. The research employed a two-stage case-finding procedure. GHQ-12 was administered to 25916 adults who consulted health-care services. The second-stage assessment (n = 5438) consisted of the Composite international Diagnostic Interview (CIDI), the Social Disability Schedule, and questionnaires. Possible cases or borderline cases of mental disorder, and a sample of known cases, were followed up at three months and one year. Using standard diagnostic algorithms (ICD-10), prevalence rates were calculated for current disorder (one-month) and lifetime experience disorder. Well-defined psychological problems are frequent in all the general health-care settings examined (median 24.0%). Among the most common were depression anxiety, alcohol misuse, somatoform disorders, and neurasthenia. Nine per cent of patients suffered from a "subthreshold condition" that did not meet diagnostic criteria but had clinically significant symptoms and functional impairment. The most common co-occurrence was depression and anxiety. Comorbidity increases the likelihood of recognition of mental disorders in general health care, and the likelihood of receiving treatment.
世界卫生组织关于“普通医疗保健中的心理问题”的合作研究，在15个国际地点调查了初级保健机构中常见心理问题的形式、频率、病程及转归。该研究采用两阶段病例发现程序。对25916名寻求医疗服务的成年人进行了一般健康问卷-12（GHQ-12）测评。第二阶段评估（n = 5438）包括复合国际诊断访谈（CIDI）、社会残疾评定量表及问卷。对可能的病例或临界病例以及已知病例样本进行了为期3个月和1年的随访。使用标准诊断算法（ICD-10）计算了当前疾病（1个月内）及终生经历疾病的患病率。在所调查的所有普通医疗保健机构中，明确界定的心理问题很常见（中位数为24.0%）。最常见的有抑郁、焦虑、酒精滥用、躯体形式障碍及神经衰弱。9%的患者患有不符合诊断标准但有临床显著症状和功能损害的“阈下状况”。最常见的共病情况是抑郁和焦虑。共病增加了在普通医疗保健中识别精神障碍的可能性以及接受治疗的可能性。
