Objective:This study aims to investigate the prevalence and distribution characteristics of mental disorders among people aged 18 and above in Shandong Province.Methods:In 2015, an epidemiological survey was carried out to investigate the patterns of mental disorders in 49 counties of Shandong Province. A total of 28 000 individuals aged 18 years or older were selected using the multistage stratified cluster sampling method. All these participants were classified as at a high or low risk of mental disorders according to the assessment results of the revised version of the General Health Questionnaire (GHQ). The diagnosis of mental disorders was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual, Forth edition (DSM-Ⅳ) axis I or MMSE. All participants at high risk of mental disorders were evaluated using DSM-Ⅳ or MMSE to confirm the psychiatric diagnoses, while 10% of participants at low risk of mental disorders were randomly selected to be evaluated. The prevalence and its 95% confidence interval of mental disorders were adjusted according to study design and sociodemographic characteristics of the sample. The between-group differences of prevalence were compared using chi-square tests or Fisher′s exact tests as appropriately.Results:A total of 27 489 individuals completed survey. The adjusted prevalence of any mental disorder was 17.46% (95 %CI 17.02%-17.89%). The five most prevalent mental disorder spectrums were substance use disorders (5.29%), mood disorders (4.47%), anxiety disorders (4.46%), intellectual and mental disorders due to physical or substance (1.91%), and psychotic disorders (1.12%). The most common mental disorders were alcohol use disorder (5.27%) and major depressive disorder (2.14%). The prevalence of mental disorders in men was higher than that in women (23.37% vs. 13.89%; χ 2=408.91, P<0.01). There was no significant difference in the prevalence of mental disorders between rural residents and urban residents (17.69% vs. 17.20%; χ2=1.05, P=0.305). Of participants with mental disorders, 26.12% (1 047/4 008) had moderate to severe functional impairment and 10.98% (428/3 898) have sought professional help. Conclusion:The prevalence of mental disorders among people aged 18 and above in Shandong Province is basically consistent with the results of similar domestic studies. The prevalence of mental disorder was higher in men than in women and was not differ in participants living in urban and rural areas. Alcohol use disorder, major depressive disorder, non-specific anxiety disorder and non-specific depressive disorder are most common mental disorders.

目的 研究抑郁障碍患者(包括重性抑郁障碍与心境恶劣障碍两个亚型)睡眠质量的特点及相关影响因素.方法 从2015年山东省18岁及以上人群精神障碍流行病学调查数据库筛查出940例抑郁障碍患者作为抑郁组,其中包括629例重性抑郁障碍患者及311例心境恶劣障碍患者,按同性别、同年龄组(相差±5岁)、同居住区域进行1:1配对,选择940名健康人群作为对照组.使用一般健康问卷(GHQ-12)、匹兹堡睡眠质量指数(PSQI)、功能大体评定量表(GAF)和一般资料调查问卷对两组进行信息采集.结果 抑郁组睡眠障碍的检出率为59.68％,对照组检出率为9.79％,两分组间检出率比较,差异有统计学意义(P<0.01).抑郁组女性、年龄≥60岁、无业/失业、受教育年限0～6年、患有躯体疾病者的PSQI总分均高于其他分组(P<0.05).在排除年龄等上述因素的影响下,抑郁组PSQI总分高于对照组(P<0.01).不同首发年龄、社会功能损害程度、抑郁类别的抑郁障碍患者,PSQI总分比较差异有统计学意义(P<0.01).对PSQI总分与患者首发年龄、GAF总分行进一步相关分析显示:PSQI总分与首发年龄呈正相关(P<0.01),与GAF总分呈负相关(P<0.01).结论 抑郁障碍患者睡眠障碍检出率高于健康人群,且重性抑郁障碍患者睡眠质量比心境恶劣障碍患者更差.女性、年龄≥60岁、无业/失业、受教育年限0～6年、患有躯体疾病均为抑郁障碍患者睡眠质量的独立危险因素.首发年龄>60岁、重性抑郁障碍与社会功能损害严重为抑郁障碍患者睡眠质量的危险因素.

目的 研究山东省6～11岁儿童行为问题现状及其与家庭成员应对方式之间的关系.方法 采用分层整群随机抽样方法,抽取山东省16地市2386名6～11岁儿童及其家庭成员,采用Achenbach儿童行为量表(CBCL)评估儿童行为问题;简易应对方式问卷(SCSQ)评估家庭成员应对方式.结果 2386名儿童中有225例存在行为问题,检出率为9.4％,其中,1171名女童及1215名男童行为问题检出例数分别为103例(8.8％)和122例(10.0％).各年龄段检出率比较差异有统计学意义(P<0.01).6～11岁女童不同年龄CBCL抑郁因子、残忍因子、攻击性因子、性问题因子分比较差异有统计学意义(P<0.05),不同年龄男童多动因子、攻击性因子分比较差异有统计学意义(P<0.05).儿童父亲、母亲、(外)祖父母、其他家庭成员的SCSQ积极应对、消极应对两个维度和积极问题关注、消极情绪关注、消极问题关注三个因子分比较差异均有统计学意义(P<0.05).除CBCL残忍因子外,6～11岁男童及女童CBCL各个因子分与家庭成员应对方式均存在相关性(P<0.05);男童的CBCL交往不良因子与SCSQ母亲的积极情绪关注因子呈正相关(P<0.05),抑郁与母亲的消极情绪关注因子呈正相关(P<0.05),抑郁、强迫、社交退缩、多动、攻击性和违纪因子与母亲的消极问题关注因子均呈正相关(P<0.05);抑郁、交往不良、强迫因子与母亲的消极应对维度均呈正相关(P<0.05);分裂样、交往不良和攻击性因子与父亲的积极情绪关注因子均呈正相关(P<0.05),交往不良、攻击性因子与父亲的消极问题关注呈正相关(P<0.05).女童CBCL躯体诉述、分裂强迫、攻击性因子与SCSQ母亲的积极应对维度和积极问题关注因子均呈正相关(P<0.05);躯体诉述、分裂强迫、攻击性、抑郁因子与母亲消极应对维度及消极情绪关注均呈正相关(P<0.05);多动因子与母亲消极应对维度呈正相关(P<0.05);违纪因子与母亲积极情绪关注呈正相关(P<0.05);多动、违纪、攻击性、抑郁因子与母亲消极问题关注因子均呈正相关(P<0.05);违纪因子与母亲心理疏导因子呈正相关(P<0.05).躯体诉述、分裂强迫、违纪因子与父亲的消极应对维度均呈正相关(P<0.05);社交退缩、躯体诉述、分裂强迫,多动、违纪和攻击性因子与父亲消极问题关注因子均呈正相关(P<0.05);残忍因子与父亲积极情绪关注因子呈负相关(P<0.05).结论 儿童行为问题与父母应对方式存在相关性.过于积极和过于消极的应对方式对儿童成长均不利.

目的 了解山东省12～16岁青少年行为问题现状及其对社会能力的影响.方法 采用多阶段分层整群系统随机抽样方法,抽取山东省16地市12～16岁青少年1 917名,选用Achenbach儿童行为量表(CBCL)进行入户调查.结果 山东省16地市12～16岁青少年行为问题总检出率为14.97％,男生检出率(12.37％)低于女生(18.29％)(P＜0.001).有行为问题的青少年,其活动能力、社交能力以及学习能力得分均低于没有行为问题的青少年(P＜0.001).结论 山东省青少年行为问题的检出率较高,且行为问题对青少年社会能力造成明显影响.

目的 了解临沂市18岁及以上人群中精神疾病的患病情况,为制定本地区精神卫生工作规划提供科学依据.方法 采用整体分层抽样的方法随机抽取研究对象,使用GHQ筛查表,对筛查出的高危、中危和部分低危者依据SCID-I/P和MMSE作出精神障碍诊断.结果 3670人完成筛查和诊断,30日现患标准化患病率为12.96％,排在前4位的分别是焦虑障碍(3.33％)、心境障碍(3.17％)、酒精使用障碍(2.04％)、器质性障碍(1.23％).结论 精神障碍患病水平在逐渐升高,已经成为必须加强综合干预的公共卫生问题.

Objective To investigate the prevalence of behavioral problems and explore their relevant factors in children aged 6 ～ 11 years in Shandong province. Methods A total of 2 635 children aged 6 ～ 11 years from 16 cities of Shandong province were investigated by multi-stage stratified random sampling and assessed with Achenbach Child Behavior Checklist (CBCL) . Results The prevalence of behavior problems was 11. 1％ in children,and there was no statistically significant difference between 10. 8％ in boys and 11. 8％ in girls (P > 0. 05) . However,the differences of behavior problem prevalences among ages were significant (P < 0. 05) . Logistic regression revealed that father's hobby,family income,father's health,number of friends and quality of companion relationship might contribute to the behavior problems in children (P < 0. 05) . Conclusion The prevalence of behavioral problems in children is at a high level,which may be correlated with many factors with family factors as an important one.

Objective To compare the curative effect and safety of sulfasalazine enteric tablets and enteric capsule in the maintenance treatment of ulcerative colitis (UC) .Methods 210 cases of UC after being given sulfasalazine enteric tablets were randomly divided into the treatment group of sulfasalazine enteric tablets (Group A of 110 cases) and the group of enteric capsule (Group B of 100 cases ) for maintenance treat-ment .The observation period was 12 weeks ,and the curative effect and safety were assessed every 4 weeks .Results In the 4th ,8th and 12th weeks ,the continuous effective rates were 68 .38% ,65 .45% and 63 .63% respectively in Group A and 69% ,66% 、63 .63% and 64 .13% respectively in Group B .The cura-tive effect in the 12th week was found lower than that in the 4th weeks ( P < 0 .05) .Conclusion Sul-fasalazine enteric tablets and enteric capsule ?can produce good curative effect and safety after long-term maintenance treatment of UC .

目的 探讨洛非西定(Lofexidine)对酒精所致震颤谵妄的治疗效果和安全性.方法 将住院的80例酒精所致震颤谵妄患者随机分为研究组(洛非西定治疗组)和对照组(地西泮治疗组),在营养支持治疗的基础上分别给予常规治疗剂量的口服药物,于入组时及治疗后第4、7、10天行酒精戒断综合征评定量表(CIWA-Ar)评定.结果 第3次评定CIWA-Ar量表总分对照组高于研究组,有显著性差异(P＜0.05);震颤和定向力因子评分对照组高于研究组,有显著性差异(P＜0.01).第3次评定两组减分率为82.98％和80.68％,第4次评定两组减分率分别为96.95％和96.93％,两组第3、4次评定减分率均达到显著有效水平(减分率＞75％).结论 洛非西定与地西泮比较,治疗酒精所致震颤谵妄疗效确切,不良反应轻微.

Objective To survey the depressive mood disorders and related factors of chronic non-specific (ulcerative) colitis in patients to provide the basis for effective interventions.Methods 50 cases of chronic non-specific colitis patients and 50 healthy controls were selected respectively to complete EPQ,LES,SDS scale test.The data of their sex,cultural level and therapeutic aspects were also collected and the data were analyzed by means of average inspection,chi-square test,correlation analysis and multivariate stepwise regression.Results 48%of the patients showed depressive mood disorder(χ~2 = 19.841,P 0.01), more negative life event frequency(χ~2=4.1095,P 0.05),average frequency for each patient(u =7. 589,P 0.01).According to the SDS as the dependent variable in regression analysis,α= 0.15,N,E, curative effect and age were selected as the related factors,with the partial regression coefficients being (7.4688,4.6406,4.5706,4.3959) respectively and P-values being(0.0007,0.0341,0.0336,0.0383) respectively. Conclusion The incidence of depressive mood disorder amounts to 48%in chronic non-specific colitis patients,and the risk factors are mainly personality defects,age clinical effect.

<正>1病例资料患者女,77岁,农民,已婚。患者于2008年10月7日晨起床后自感头晕,即到当地卫生室按"感冒"进行输液治疗,期间感到口渴,喝水突然呛咳,患者立刻认为自己"不会咽东西了"。急送当地医院,做血、尿常规、肝功、血糖、血脂、胸透、心电图、胃镜、头颅核磁

1 病例介绍 患者女性,18岁,农民,未婚.门诊号:68644,住院号:28758.患者于2008年5月6日,突然全身多处出现斑点状皮下出血痕,以四肢末端为重,无不适感,起初并未引起重视,一周后,出血点有增多和范围扩大趋势,住入当地医院治疗,检查发现血小板减少,诊断为"特发性血小板减少性紫癜",给予糖皮质激素治疗,5月20日,患者突然出现精神症状,表现言语行为紊乱,或长时间一言不发,或不自主哭、笑,或独自高声对空讲话,或胡乱骂人,或摔砸器物.考虑系糖皮质激素诱发精神障碍,停止使用该类药物,给予长春新碱治疗,直至2008年7月11日,血小板虽然恢复正常水平,但精神症状及全身紫癜持续存在,家人慕名来我院求治.发病来无自伤、自杀言行.

目的评价利培酮和无抽搐电休克对难治性精神分裂症的疗效和副反应。方法将住院的难治性精神分裂症60例,随机分为两组,分别应用利培酮和无抽搐电休克治疗,观察12周。用PANSS量表评定疗效,用TESS量表评定药物副反应。结果利培酮治疗组(在2周内逐渐停用原有抗精神病药)从治疗第6周起PAN-SS量表总分、PANSS量表一般精神病理分和阳性症状分开始下降,第8周起全面下降,各治疗时段TESS评分不大于3,观察期末评定有效率为56.67%,显效率为13.33%。MECT组(将原有抗精神病药减量至2/3-1/2)自治疗第4周起PANSS量表总分、PANSS量表一般精神病理分和阳性症状分开始下降,观察期末,有效率为63.33%,显效率为20%,但TESS评分较高。结论上述两种方法对难治性精神分裂症均有较理想治疗效果。

目的探讨精神分裂症患者自我“年龄虚减”性判断、认定错误的临床现象的特点和实质。方法分析1586例精神分裂症住院患者中,存在自我“年龄虚减”性判断、认定错误患者的一般人口学资料及临床资料。结果有9例(0.57%)存在自我“年龄虚减”性判断、认定错误,临床表现为判断自已年龄的思维独到地荒谬离奇,其错误无法用推理、计算、对比、照镜子等方法进行自我更正,以慢性型或衰退期患者居多。结论精神分裂症病人的“年龄虚减”性判定错误,应归属一种妄想表现,可以命名为年轻化妄想(或年龄幼稚化妄想)。

目的探讨利培酮治疗Tourette综合征的疗效、安全性和耐受性。方法将100例7~16岁的Tourette综合征患儿随机分为利培酮治疗组和氟哌啶醇治疗组,并于入组时及治疗第2周、第4周、第8周末用耶鲁抽动症整体严重程度量表(Yale Glibal Tic Severity Scale,YGTSS)、副反应评定量表(TESS)和临床疗效总评量表(CGI)评定病情变化、药物副反应和临床总体疗效。结果在治疗第2周末、第4周末、第8周末,临床疗效及临床总体疗效评定,两组患者间差异无统计学意义(P>0.05),TESS评分差异具有非常显著意义(t=3.52,P<0.01)。结论利培酮治疗Tourette综合征疗效与氟哌啶醇相当,但毒副反应较轻微,其安全性及耐受性更好。

目的验证万拉法新治疗精神分裂症后抑郁的疗效及安全性.方法对65例精神分裂症后抑郁患者随机入组,分别以万拉法新与氯丙咪嗪治疗6周.采用汉密尔顿抑郁量表(HAMD)、简明精神病量表(BPRS)、阴性症状量表(SANS)评定临床疗效,采用副反应量表(TESS)评定副反应.结果万拉法新组与氯丙咪嗪组治疗前后HAMD、BRPS、SANS评分及减分率比较均无显著性差异(P＞0.05).万拉法新组的副反应较氯丙咪嗪组少而轻,但各有1例精神病症状恶化.结论万拉法新治疗精神分裂症后抑郁的疗效确切,但极个别病例精神病症状恶化.

对精神疾病患者进行眉间距离观察,报告如下. 1 对象与方法 为1999年1～10月间住本院的精神疾病患者随机抽取655例,其中精神分裂症500例,情感性精神障碍155例,均符合CCMD-2-R诊断标准,全部病人行眉间距离测查,以258例健康者作对照.精神分裂症组男336例,女164例;情感性精神障碍组男111例,女44例;对照组男187例,女71例.3组平均年龄分别为:(33.1±5.7)岁,(28.7±10.2)岁和(34.5±11.4)岁,3组间均无显著差异(P>0.05).