Zheng Y P, Lin K M, Takeuchi D, Kurasaki K S, Wang Y, Cheung F
Research Center on the Psychobiology of Ethnicity, Harbor-UCLA Medical Center, Torrance 90502, USA.
Compr Psychiatry. 1997 Sep-Oct;38(5):249-59. doi: 10.1016/s0010-440x(97)90056-0.
This study examined the prevalence and clinical features of ICD-10-defined neurasthenia (NT) in Chinese-Americans and its relations to other psychiatric disorders. In this community epidemiological survey, the enhanced Composite International Diagnostic Interview [CIDI], with a supplemental NT module, was administered to 1,747 Chinese-Americans, selected with a stratified cluster sampling method. The SCL-90-R was also used for measuring psychiatric morbidity and symptoms. Dimensions of social stress and social support were measured by established instruments. A total of 112 ICD-10 NT subjects (6.4%) were identified. Of these, 63 (56.3%) did not experience any current and lifetime DSM-III-R diagnoses, yielding a 12-month or lifetime prevalence rate of "pure" NT of 3.61%. This rate was much higher than any of the other psychiatric disorders in this sample. Compared with normal subjects, "pure" NT subjects had significantly higher SCL-90-R total and factor scores, experienced more psychosocial stress, and perceived less social support (P < .05 or .01). Compared with subjects with depression and anxiety disorders, "pure" NT cases reported significantly less SCL-90-R psychological symptoms (P < .05 or .01), but had a strikingly similar elevation in the somatization subscale score. These data suggest that NT is a distinctive clinical condition overlapping only partially with the other better recognized diagnostic entities. In view of its high prevalence and the salience of its impact on the health of those afflicted, it is imperative that concerted research efforts be made to further elucidate the temporal stability, natural course, and outcome of such a condition.
本研究调查了华裔美国人中由国际疾病分类第十版(ICD - 10)定义的神经衰弱(NT)的患病率、临床特征及其与其他精神障碍的关系。在这项社区流行病学调查中,采用分层整群抽样方法选取了1747名华裔美国人,对其实施了增强版复合国际诊断访谈(CIDI),并附加了NT模块。症状自评量表(SCL - 90 - R)也用于测量精神疾病发病率和症状。社会压力和社会支持维度通过既定工具进行测量。共识别出112名ICD - 10 NT患者(6.4%)。其中,63名(56.3%)在当前及一生均未经历任何精神疾病诊断与统计手册第三版修订本(DSM - III - R)诊断,“单纯”NT的12个月或一生患病率为3.61%。该患病率远高于本样本中的其他任何精神障碍。与正常受试者相比,“单纯”NT受试者的SCL - 90 - R总分及因子分显著更高,经历更多心理社会压力,且感知到的社会支持更少(P < 0.05或0.01)。与抑郁症和焦虑症患者相比,“单纯”NT患者报告的SCL - 90 - R心理症状显著更少(P < 0.05或0.01),但在躯体化分量表得分上却有惊人相似的升高。这些数据表明,NT是一种独特的临床状况,仅部分重叠于其他更被认可的诊断实体。鉴于其高患病率及其对患者健康影响的显著性,必须共同开展研究工作,以进一步阐明这种状况的时间稳定性、自然病程和转归。