天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (12): 1320-1323.doi: 10.11958/20170627

• 流行病学调查 • 上一篇    下一篇

天津市社区人群创伤性事件的暴露率及其与 重性抑郁障碍的关系

陈征 1， 2， 马骏 1△， 徐广明 2△， 尹慧芳 2   

  1. 基金项目： 天津市卫生行业重点攻关计划项目 （13KG119） 作者单位： 1 天津医科大学 （邮编 300070）； 2 天津市安定医院 作者简介： 陈征 （1980）， 男， 在职研究生， 副主任医师， 主要从事精神心理治疗方向研究 △通讯作者 马骏 E-mail: majun@tijmu.edu.cn； 徐广明 E-mail: xugm@ymail.com
  • 收稿日期:2017-06-02 修回日期:2017-11-08 出版日期:2017-12-15 发布日期:2017-12-15
  • 通讯作者: 马骏 E-mail:majun@tijmu.edu.cn

The relationship between traumatic event exposure rate and major depressive disorder prevalence in community population in Tianjin

CHEN Zheng1,2, MA Jun1△, XU Guang-ming2△, YIN Hui-fang2   

  1. 1 Tianjin Medical University, Tianjin 300070, China; 2 Tianjin Anding Hospital △Corresponding Author MA Jun E-mail: majun@tijmu.edu.cn; XU Guang-ming E-mail: xugm@ymail.com
  • Received:2017-06-02 Revised:2017-11-08 Published:2017-12-15 Online:2017-12-15
  • Contact: JUN MA E-mail:majun@tijmu.edu.cn

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摘要： 目的 调查天津市社区人群创伤性事件的暴露情况， 探讨创伤性事件与重性抑郁障碍（MDD）患病的关 系。方法 采用多阶段整群随机抽样的方法， 对 2011 年天津市 18 个区县的 15 538 个家庭中 18 岁以上人群进行一 般健康问卷 （12 项， GHQ-12） 调查， 在完成调查的 11 748 例对象中， 根据罹患精神障碍的危险等级， 按照高危 100%、 中危 40% 和低危 10% 的比例抽取调查对象。最终选取 4 438 名社区居民采用美国精神障碍诊断及统计手册第 4 版 （DSM-Ⅳ） 轴Ⅰ诊断临床定式检查患者版 （SCID-Ⅰ/P） 进行定式访谈， 了解受调查者创伤性事件的暴露情况和 MDD 的患病率。Logistic 回归分析罹患 MDD 的影响因素。结果 4 438 例受调查者中 469 例经历过创伤性事件， 调整后 的总暴露率为 10.3%。469 例创伤性事件的暴露者中 76 例罹患 MDD， 调整后的患病率为 6.7%。而无创伤性事件暴 露的人群中 MDD 患病率为 3.3%。Logistic 回归分析显示女性 （OR=1.77， 95%CI： 1.27~2.46）、 丧偶/离异、 经历创伤性 事件（OR=2.21， 95%CI： 1.46~3.34）是罹患 MDD 的危险因素。结论 天津市社区人群创伤性事件的总暴露率为 10.3%， MDD 的患病与是否有过创伤性事件经历有关； 建议全社会广泛动员参与， 更加关注高危人群的心理健康 问题。

关键词: 流行病学研究, 应激障碍, 创伤性, 急性, 抑郁症, 暴露, 天津, 重性抑郁障碍, 社区人群

Abstract: Objective To investigate the prevalence of traumatic event exposure and its relationship with major depressive disorder (MDD) in community population in Tianjin. Methods A multi-stage cluster random sampling method was used for the general health questionnaire (GHQ-12) in the population aged above 18 in 15 538 families of 18 counties in Tianjin city. Among the 11 748 subjects who completed the survey, they were divided into the high-risk group (100%), medium risk group (40%) and low risk group (10%) according to the risk level of mental disorders. Finally, 4 438 residents were interviewed with the diagnostic and statistical manual of mental disorders Fourth Edition (DSM-Ⅳ) axis Ⅰ diagnostic clinical interview version (SCID-Ⅰ/P). The prevalence of respondents exposed to traumatic events and MDD was calculated. Logistic regression analysis was applied to obtain the risk factors of MDD. Results A total of 469 people experienced traumatic events in 4 438 subjects, and the adjusted total exposure rate was 10.3%. Seventy-six people suffered from MDD in 469 cases with traumatic events, and the adjusted total exposure rate was 6.7%. The prevalence of MDD was 3.3% in people with no traumatic events. Logistic regression analysis showed that female (OR=1.77， 95%CI： 1.27-2.46), widowed/ divorced and experienced a traumatic event (OR=2.21， 95%CI： 1.46-3.34) were the risk factors of MDD. Conclusion The total exposure rate of traumatic events is 10.3% in community residents in Tianjin, and the prevalence of MDD is related with the traumatic event exposure. It is suggested that the whole society should mobilize and participate extensively, and pay more attention to the psychological health problems of high risk population.

Key words: epidemiologic studies, stress disorders, traumatic, acute, depressive disorder, expose, Tianjin, major depressive disorder, community population