深圳市宝安区严重精神障碍患者现况调查

陈卿; 刘成锋; 韩明辉; 卿利; 卢楚虹; 程娟; 胡付兰; 张明; 胡东生; 郭艳芳

doi:10.16462/j.cnki.zhjbkz.2020.11.014

深圳市宝安区严重精神障碍患者现况调查

doi: 10.16462/j.cnki.zhjbkz.2020.11.014

1.
518100 深圳，深圳市宝安区慢性病防治院精神卫生中心
2.
518061 深圳，深圳大学公共卫生学院生物统计与流行病学系

基金项目:

深圳市宝安区科技创新局-2020年宝安区医疗卫生基础研究项目 2020JD099

详细信息

通讯作者:
陈卿，E-mail：cq7922446@163.com

中图分类号: R749
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出版历程
- 收稿日期: 2020-08-06
- 修回日期: 2020-09-10
- 刊出日期: 2020-11-10

Cross-sectional study of patients with severe mental disorders from Bao'an District in Shenzhen

1.
Center of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518100, China
2.
Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University, Shenzhen 518061, China

Funds:

Bao'an District Science and Technology Innovation Bureau in Shenzhen-Bao'an District Medical and Health Basic Research Project in 2020 2020JD099

More Information

Corresponding author: CHEN Qing, E-mail: cq7922446@163.com

摘要

摘要: 目的了解深圳市宝安区目前六种在册严重精神障碍患者的患病率及人口统计学特征，为制定严重精神障碍的防治策略提供科学依据。方法选取2019年6月30日前纳入深圳市精神卫生信息管理系统的宝安区患者，对其人口统计学特征进行分析。结果宝安区共登记在册严重精神障碍患者7 835例，现住址在宝安区的患者共有6 408例。全区报告患病率为1.97‰，其中最高的是西乡街道(2.95‰)，最低的是新桥街道(0.83‰)。在六种严重精神障碍中，精神分裂症最多，占60.82%，其次为双相情感障碍(17.03%)和精神发育迟滞伴发精神障碍(15.48%)。患病人群主要集中在18~44岁年龄组(61.01%)，文化程度较低，未婚人士居多；患者合并高血压和糖尿病患病率分别为1.44%和1.46%；个案管理率为3.17%。在2010―2018年间，年度登记病例数和报告发病率都呈现双峰型变动趋势。结论精神分裂症是宝安区严重精神障碍综合防控的重点病种，不同类型的严重精神障碍患者具有不同的人口统计学构成，患者的慢性非传染性疾病的筛查和个案管理有待进一步加强。
- 严重精神障碍 /
- 病例系列分析 /
- 患病率 /
- 发病率
Abstract: Objective To understand the prevalence and epidemiological features of six severe mental disorders in Bao'an District, Shenzhen City, so as to provide scientific evidence for developing severe mental disorders prevention and control strategy. Methods The patients who were included in the mental health information management system in Bao'an District before 30 June 2019 were selected to analyze their demographic characteristics. Results A total of 7 835 patients with severe mental disorders were registered in Bao'an District, 6 408 of whom live in this district. The reported prevalence of six severe mental disorders was 1.97‰, with the highest in Xi'xiang street (2.95‰) and the lowest in Xin'qiao street (0.83‰). Among the six categories of severe mental disorders, schizophrenia was the most common disease (60.82%), followed by bipolar disorder (17.03%) and mental retardation accompanied by mental disorder (15.48%). Patients with severe mental disorders were mainly in age of 18 to 44 years old (61.01%), which had a low level of education and most of them were unmarried. In addition, the prevalence rates of hypertension and diabetes among patients were 1.44% and 1.46%, respectively. The case management rate of severe mental disorders for patients was 3.17%. The annual number of registered cases and reported incidence both showed a bimodal trend from 2010 to 2018. Conclusions Schizophrenia is the key disease for prevention and treatment in Bao'an District of Shenzhen City. Patients with different severe mental disorders types have different demographic composition, and the screening and case management of patients with chronic non-communicable diseases need to be further strengthened.
- Severe mental disorders /
- Case series analysis /
- Prevalence rate /
- Incidence rate

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图 1 2010―2018年宝安区管理在册严重精神障碍患者年度报告发病率

Figure 1. Annual reported incidence of severe mental disorders registered in Bao'an District from 2010 to 2018

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表 1 2019年宝安区各街道六种在册严重精神障碍患者患病率

Table 1. Prevalence of six severe mental disorders registered in the streets of Bao'an District in 2019

行政区划	常住人口	在册患者数(n)	报告患病率(‰)
新安街道	457 886	1 264	2.76
西乡街道	481 736	1 420	2.95
航城街道	279 447	519	1.86
福永街道	279 128	463	1.66
福海街道	312 046	299	0.96
沙井街道	376 456	736	1.96
新桥街道	279 917	232	0.83
松岗街道	312 842	498	1.59
燕罗街道	144 337	206	1.43
石岩街道	334 027	771	2.31
合计	3 257 822	6 408	1.97

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表 2 2019年宝安区管理六种在册严重精神障碍患者患病率

Table 2. Prevalence of six severe mental disorders registered in Bao'an District in 2019

诊断分类	在册患者数(n)	报告患病率(‰)
精神分裂症	3 767	1.16
偏执性精神障碍	53	0.02
分裂情感性障碍	235	0.07
双相情感障碍	1 070	0.33
癫痫所致情感障碍	140	0.04
精神发育迟滞伴发精神障碍	1 143	0.35

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表 3 2019年宝安区管理六种在册严重精神障碍患者构成状况[n(%)]

Table 3. Composition of six severe mental disorders registered in Bao'an District in 2019 [n(%)]

变量	精神分裂症(n =4 765)	双相情感障碍(n=1 334)	癫痫所致精神障碍(n=157)	精神发育迟滞伴发精神障碍(n =1 213)	分裂情感性障碍(n=297)	偏执型精神病(n=69)	χ²值	P值
性别							209.07	＜0.001
男	2 268(47.60)	688(51.57)	106(67.52)	836(68.92)	118(39.73)	34(49.28)
女	2 497(52.40)	646(48.43)	51(32.48)	377(31.08)	179(60.27)	35(50.72)
年龄(岁)							1 573.59	＜0.001
＜18	53(1.11)	33(2.47)	16(10.19)	638(52.60)	3(1.01)	-
18~	3 077(64.58)	948(71.06)	96(61.15)	425(35.04)	215(72.39)	19(27.54)
45~	1 164(24.43)	241(18.07)	37(23.57)	119(9.81)	58(19.53)	25(36.23)
≥60	471(9.88)	112(8.40)	8(5.10)	31(2.56)	21(7.07)	25(36.23)
户籍							1 157.24	＜0.001
深圳户籍	1 062(22.29)	351(26.31)	62(39.49)	875(72.14)	68(22.90)	16(23.19)
非深圳户籍	3 703(77.71)	983(73.69)	95(60.51)	338(27.86)	229(77.10)	53(76.81)
文化程度							2 338.21	＜0.001
小学及以下	840(17.63)	110(8.25)	66(42.04)	939(77.41)	30(10.10)	18(26.09)
初中/高中	2 352(49.36)	619(46.40)	61(38.85)	119(9.81)	146(49.16)	22(31.88)
大学及以上	423(8.88)	283(21.21)	8(5.10)	3(0.25)	36(12.12)	8(11.59)
不详	1 150(24.13)	322(24.14)	22(14.01)	152(12.53)	85(28.62)	21(30.43)
职业类型							980.43	＜0.001
在岗	2 118(44.45)	623(46.70)	51(32.48)	372(30.67)	138(46.46)	29(42.03)
在校学生	57(1.20)	62(4.65)	6(3.82)	10(0.82)	3(1.01)	-
无业	1 610(33.79)	375(28.11)	64(40.76)	442(36.44)	90(30.30)	17(24.64)
退休	129(2.71)	42(3.15)	2(1.27)	263(21.68)	7(2.36)	8(11.59)
其他	851(17.86)	232(17.39)	34(21.66)	126(10.39)	59(19.87)	15(21.74)
精神疾病家族史							20.33	0.026
有	424(8.90)	116(8.70)	6(3.82)	88(7.25)	22(7.41)	4(5.80)
无	3 339(70.07)	903(67.69)	122(77.71)	868(71.56)	195(65.66)	47(68.12)
不详	1 002(21.03)	315(23.61)	29(18.47)	257(21.19)	80(26.94)	18(26.09)
婚姻状况							1 044.20	＜0.001
已婚	2 428(50.95)	696(52.17)	61(28.85)	110(9.07)	151(50.84)	50(72.46)
未婚	1 831(38.43)	509(38.16)	84(53.50)	1 060(87.39)	117(39.39)	6(8.70)
离婚	189(3.97)	55(4.12)	1(0.64)	11(0.91)	9(3.03)	4(5.80)
丧偶	52(1.09)	12(0.90)	3(1.91)	10(0.82)	2(0.67)	1(1.45)
不详	265(5.56)	62(4.65)	8(5.10)	22(1.81)	18(6.06)	8(11.59)
经济状况							37.34	＜0.001
贫困	1 275(26.76)	263(19.72)	54(34.39)	281(23.17)	74(24.92)	16(23.19)
非贫困	3 490(73.24)	1 071(80.28)	103(65.61)	932(76.83)	223(75.08)	53(76.81)
共病高血压							9.43	0.093
有	75(1.57)	18(1.35)	1(0.64)	10(0.82)	6(2.02)	3(4.35)
无	4 690(98.43)	1 316(98.65)	156(99.36)	1 203(99.18)	291(97.98)	66(95.65)
共病糖尿病							5.18	0.394
有	78(1.64)	18(1.35)	1(0.64)	12(0.99)	3(1.01)	2(2.90)
无	4 687(98.36)	1 316(98.65)	156(99.36)	1 201(99.01)	294(98.99)	67(97.10)
病情分类							96.50	＜0.001
稳定	4 119(86.44)	1 201(90.03)	145(92.36)	1 156(95.30)	267(89.90)	60(86.96)
基本稳定	194(4.07)	43(3.22)	5(3.18)	36(2.97)	11(3.70)	3(4.35)
不稳定	5(0.10)	-	-	-	-	-
不详	447(9.38)	90(6.75)	7(4.46)	21(1.73)	19(6.40)	6(8.70)
治疗效果							1 077.65	＜0.001
痊愈	34(0.71)	10(0.75)	3(1.91)	1(0.08)	-	1(1.45)
好转	3 277(68.77)	901(67.54)	111(70.70)	267(22.01)	214(72.05)	48(69.57)
无变化	336(7.05)	70(5.25)	19(12.10)	118(9.73)	16(5.39)	1(1.45)
加重	5(0.10)	3(0.22)	1(0.64)	1(0.08)	-	-
其他	1 113(23.36)	350(26.24)	23(14.65)	826(68.10)	67(22.56)	19(27.54)
是否个案管理							80.23	＜0.001
是	159(3.34)	48(3.60)	2(1.27)	26(2.14)	12(4.04)	1(1.45)
否	4 280(89.82)	1 213(90.93)	150(95.54)	1 177(97.03)	13(4.38)	64(32.75)
其他	326(6.84)	73(5.47)	5(3.18)	10(0.82)	272(91.58)	4(5.80)

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