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心境障碍知晓情况调查:一项四城市多中心研究
王萍1,黄茹燕1,黄乐萍1,吴志国2,刘修军3,刘丽萍4,张迎黎5,刘涛生6,汪作为1,6*
0
(1. 上海市虹口区精神卫生中心, 上海 200083;
2. 上海市杨浦区精神卫生中心、上海健康医学院精神卫生临床研究中心, 上海 200093;
3. 华中科技大学同济医学院附属武汉市精神卫生中心, 武汉 430030;
4. 哈尔滨市第一专科医院精神医学临床研究室, 哈尔滨 150056;
5. 深圳市精神卫生中心、深圳市康宁医院抑郁障碍科, 深圳 518020;
6. 海军军医大学(第二军医大学)心理系精神医学教研室, 上海 200433
*通信作者)
摘要:
目的 调查上海、武汉、哈尔滨、深圳四地社区居民对心境障碍知识的知晓情况及对心境障碍治疗的态度。方法 2017年6月至2019年12月招募上海、武汉、哈尔滨、深圳四地精神专科医院及社区卫生服务中心的门诊患者为调查对象,以随机抽样方式调查。采用自编心境障碍知晓率调查问卷调查被试心境障碍相关知识的知晓率及对治疗态度。所有参与者都参加了面对面的采访,评估员指导被试下载“心情温度计”手机移动终端(APP),被试在线完成问卷填写。问卷中关于心境障碍的知晓情况以多选题形式展开调查,采用多重响应分析中的频率和交叉表法进行分析。结果 共收到有效问卷1 289份。被试对于心境障碍疾病名称的知晓频率由高到低依次为抑郁症(87.9%, 1 133/1 289)、忧郁症(57.3%,739/1 289)、狂躁症(50.7%,653/1 289)、躁狂症(40.1%,517/1 289)、双相情感障碍(23.6%,304/1 289)、躁狂抑郁症(23.1%,298/1 289)、心境障碍(22.6%,291/1 289)、躁狂发作(21.3%, 275/1 289)、双相障碍(14.4%,185/1 289)、轻躁狂(14.0%,180/1 289)。被试对于抑郁症和躁狂症典型案例的识别率分别是61.5%(793/1 289)及41.9%(540/1 289),精神专科门诊、女性、学生及在职、离异/分居、文化程度较高的被试对于抑郁症和躁狂症的识别率较高。被试获悉心境障碍知识的主要途径有网络、电视广播、杂志书籍、亲戚朋友和社区宣传。对于获取心境障碍知识的必要性,66.2%(853/1 289)的被试认为有必要,30.7%(396/1 289)认为没必要,3.1%(40/1 289)未做选择。对于心境障碍治疗方式的态度,62.2%(802/1 289)的被试认为需要心理治疗和药物治疗,13.9%(179/1 289)认为只需要心理治疗(或心理咨询),4.8%(62/1 289)认为不治疗;不同性别、职业、婚姻状况和文化程度的被试对心境障碍治疗方式的态度差异均有统计学意义(P均<0.01),其中女性、在职、已婚/同居、文化程度较低的被试多认为不仅需要心理治疗,还需要药物治疗。结论 上海、武汉、哈尔滨、深圳四地居民对心境障碍尤其是躁狂症和双相障碍知识的总体知晓水平并不乐观,仍应加强对心境障碍知识的普及和宣传力度,以提高心境障碍的早期识别和规范诊治水平。
关键词:  心境障碍  抑郁症  躁狂症  知晓率  治疗态度
DOI:10.16781/j.CN31-2187/R.20220723
投稿时间:2022-09-09修订日期:2023-02-21
基金项目:国家重点研发计划(2016YFC1307105),上海市医学重点专科建设计划(ZK2019A06),上海市精神心理疾病临床医学研究中心项目(19MC1911100),上海市卫生健康委员会科研课题(202040318),上海市虹口区卫生健康委员会临床重点扶持专科项目(HKZK2020A11),上海市虹口区卫生和计划生育委员会重点科研课题(虹卫1602-11),上海市虹口区精神卫生中心优秀人才培养计划(2023XKDTR01).
Awareness of mood disorders: a 4-city multicenter study
WANG Ping1,HUANG Ruyan1,HUANG Leping1,WU Zhiguo2,LIU Xiujun3,LIU Liping4,ZHANG Yingli5,LIU Taosheng6,WANG Zuowei1,6*
(1. Mental Health Center of Hongkou District, Shanghai 200083, China;
2. Mental Health Center of Yangpu District & Clinical Research Center of Mental Health, Shanghai University of Medicine & Health Sciences, Shanghai 200093, China;
3. Mental Health Center of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China;
4. Clinical Research Laboratory of Psychiatry, The First Psychiatric Hospital of Harbin, Harbin 150056, Heilongjiang, China;
5. Department of Depressive Disorders, Shenzhen Mental Health Center & Shenzhen Kangning Hospital, Shenzhen 518020, Guangdong, China;
6. Department of Psychiatry, Faculty of Psychology, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To investigate the knowledge of mood disorders and attitude towards the treatment of mood disorders among community residents in Shanghai, Wuhan, Harbin and Shenzhen. Methods From Jun. 2017 to Dec. 2019, outpatients from psychiatric hospitals and community health centers in Shanghai, Wuhan, Harbin and Shenzhen were recruited as the survey subjects, and were investigated by random sampling. A self-designed questionnaire on awareness of mood disorders was used to investigate the knowledge of mood disorders and attitude towards the treatment. In a face-to-face interview, the evaluators instructed the participants to download the “mood thermometer” mobile terminal (APP), and the participants completed the survey online. The awareness of mood disorders was investigated by multiple-choice questions. The frequency and cross-tabulation methods in multiple response analysis were used for analysis. Results The survey received a total of 1 289 valid questionnaires. The frequency of knowing the name of mood disorders from high to low was major depressive disorder (87.9%, 1 133/1 289), melancholic depression (57.3%, 739/1 289), mania psychosis (50.7%, 653/1 289), mania (40.1%, 517/1 289), bipolar affective disorder (23.6%, 304/1 289), manic-depressive disorder (23.1%, 298/1 289), mood disorder (22.6%, 291/1 289), manic episode (21.3%, 275/1 289), bipolar disorder (14.4%, 185/1 289), and hypomania (14.0%, 180/1 289). The recognition rates for typical cases of depressive disorder and mania were 61.5% (793/1 289) and 41.9% (540/1 289), respectively. Specialist clinics, women, students and on the job, divorce/separation and higher education level were associated with high recognition rates of depressive disorder and mania. The participants learned about the mood disorder knowledge through the Internet, television broadcasting, magazines and books, relatives and friends, and community publicity. Regarding the necessity of acquiring knowledge of mood disorders, 66.2% (853/1 289) of the participants thought that it was necessary, 30.7% (396/1 289) considered it was unnecessary, and 3.1% (40/1 289) chose not to answer. Regarding the attitude towards mood disorder treatment strategies, 62.2% (802/1 289) of the participants thought that psychotherapy and medication were needed, 13.9% (179/1 289) thought that psychotherapy only (or counseling) was needed, and 4.8% (62/1 289) thought that there was no treatment. There were significant differences in the attitudes towards the treatment strategies of mood disorders among the participants with different genders, occupations, marital statuses and education levels (all P<0.01). The female, working, married/cohabiting, and lower educated participants believed that not only psychotherapy was needed, but also medication. Conclusion The overall awareness level of community residents in Shanghai, Wuhan, Harbin and Shenzhen on mood disorders, especially mania and bipolar disorder, is unsatisfactory. It is still necessary to strengthen the popularization and publicity of mood disorder knowledge, so as to improve the early recognition and standard diagnosis and treatment of mood disorders.
Key words:  mood disorder  depression  mania  awareness rate  treatment attitude