目的:分析淄博市严重精神障碍患者管理治疗状况,为相应防治措施的制定提供依据,为进一步开展严重精神障碍治疗工作及政府各相关部门制定救治救助政策提供参考.方法:采用描述性分析方法,对截至2019年12月31日全市在山东省精神障碍信息系统的严重精神障碍患者的一般信息、服药治疗、未治期、病程进行统计分析.结果:截至2019年底,淄博市在册严重精神障碍患者20301例,服药患者18307例,服药率90.18％;规律服药患者13722例,规律服药率67.59％;全市持续不服药患者671例,占在册患者的3.31％.在册6种严重精神障碍患者中,癫痫所致精神障碍服药率(93.96％)和规律服药率(72.03％)最高;双相情感障碍服药率(84.24％)和精神发育迟滞伴发精神障碍规律服药率(57.65％)最低;精神分裂症患者的服药率90.79％,规律服药率70.74％.2019年74.61％患者未治期≤2年,43.82％患者病程>10年.结论:淄博市在册严重精神障碍患者规律服药率有待提高,管理治疗形势严峻,治疗水平需进一步提高.

目的 分析2019年淄博市严重精神障碍患者管理治疗现状.方法 采用描述性分析方法,对山东精神障碍信息系统中(截至2019年12月31日)淄博市患者的一般信息、管理治疗等情况进行分析.结果 截至2019年底全市登记在册严重精神障碍患者20301例,报告患病率4.31‰,其中沂源县最高(6.08‰),张店区最低(3.12‰);疾病分布以精神分裂症(65.56％)为主,其次是精神发育迟滞伴发精神障碍(18.83％).全市在册患者管理率93.48％,规范管理率88.96％,高新区规范管理率最高(96.98％),周村区最低(77.00％);在册患者服药率90.18％,规范服药率67.59％,博山区规律服药率最高(88.29％),高青县最低(47.12％);患者病情稳定率99.75％,面访率92.69％.在册患者中,贫困患者占44.57％,精准扶贫对象27.22％,领取监护补助的28.59％,领取精神残疾证的25.15％,为家庭医生签约服务对象的87.23％,为关爱帮扶小组服务对象的67.86％,参加社区康复服务的58.55％.结论 淄博市严重精神障碍总体管理现状良好,但是部分地区差距较大,需要有针对性地对其优化,特别是规律服药率、社区康复等亟待提高.

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 调查了解山东省淄博市18岁以上人群的应对方式,分析影响人群应对方式的影响因素.方法 选择2015年9月至2016年4月淄博市18岁以上的2965人进行了对应的调查,其中共有2750人完成了问卷调查,采用的方法为分阶段分层整群系统随机抽样法.调查结束后对不同性别、是否患病、不同受教育程度的人群实际应对方式进行对比和分析.结果 与女性、40岁以上、教育程度初中及以下、心理健康状况不好的人群相比,男性、40岁以下、教育程度高中及大学以上、心理健康状况好的人群倾向于选择积极的应对方式,差异有统计学意义(P<0.05).结论 性别、年龄、受教育年限、身心健康状况可能是应对方式的影响因素.建议多关注女性、中老年人、低受教育程度等特征的重点人群.

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.

Objective To investigate the prevalence and distribution of mental disorders in adults(age≥18) in Zibo city of Shandong province. Methods A total of 2 839 adults(age≥18) in Zibo city were screened with General Health Questionnaire (GHQ-12) ,and those who were screened out were diagnosed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version (SCID-I /P) . Results The overall prevalence of mental disorders was 16. 38％,and the sequence for prevalence of common mental disorders from high to low was substance use disorder(5. 14％) ,mood disorder(4. 86％) ,anxiety disorder(4. 05％) ,schizophrenia and other psychiatric disorders(1. 20％) ,dementia(0. 85％) ,mental retardation(0. 28％) . The prevalence of substance use disorder in males was significantly higher than that in females(P < 0. 01) ; the prevalences of mood disorder and anxiety disorder in females were significantly higher than those in males(P < 0. 01) ; the prevalence of overall mental disorders in males was significantly higher than that in females(P < 0. 01) . Conclusion Prevalence of mental disorders in Zibo increases obviously compared with the data before,and mental health problems have become important public health problem and serious social problem,which is worthy of social attention.

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.

为探讨精神分裂症发生过程中遗传与环境两危险因素及相互作用关系,我们对本病在不同社会历史环境下进行了遗传流行病学一些资料的比较与分析,现报道如下.