Lifetime prevalence of psychotic and bipolar I disorders in a general population
Lifetime prevalence of psychotic and bipolar I disorders in a general population
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DOI：
10.1001/archpsyc.64.1.19
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发表时间：
2007-01-01
影响因子：
--
通讯作者：
Lonnqvist, Jouko
中科院分区：
文献类型：
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作者：
Perala, Jonna;Suvisaari, Jaana;Lonnqvist, Jouko
背景：最近对精神障碍的一般人群调查发现，终生患病率较低。然而，这可能是由于方法上的问题。很少有研究报道所有特定精神障碍的患病率。目的：为特定精神障碍的终生患病率提供可靠的估计。设计：一般人群调查。背景和对象：采用综合国际诊断访谈、自报诊断、体检和国家登记，对8028名30岁或以上的全国代表性样本进行精神障碍和双相I型障碍的筛查。那些被筛选出来的人随后被DSM-IV的结构化临床面试重新面试。最佳估计的DSM-IV诊断是通过结合访谈和病例记录数据而形成的。主要观察指标：根据DSM-IV诊断精神障碍或双相情感障碍。结果：所有精神障碍的终生患病率为3.06%，如果包括无反应者组的注册诊断，则上升至3.48%。终生患病率分别为：精神分裂症0.87%，分裂情感性精神障碍0.32%，分裂样精神障碍0.07%，妄想障碍0.18%，双相I型障碍0.24%，以精神病为特征的抑郁障碍0.35%，物质所致精神障碍0.42%，一般内科疾病所致精神障碍0.21%。国家医院出院登记表是筛选中最可靠的(kappa=0.80)。补充访谈的病例记录对于精神障碍的具体诊断是必不可少的。结论：多来源的信息对于准确估计精神障碍的终生患病率是必不可少的。综合分析表明，其终生患病率超过3%。
Context: Recent general population surveys of psychotic disorders have found low lifetime prevalences. However, this may be owing to methodological problems. Few studies have reported the prevalences of all specific psychotic disorders.Objective: To provide reliable estimates of the lifetime prevalences of specific psychotic disorders.Design: General population survey.Setting and Participants: A nationally representative sample of 8028 persons 30 years or older was screened for psychotic and bipolar I disorders using the Composite International Diagnostic Interview, self-reported diagnoses, medical examination, and national registers. Those selected by the screens were then reinterviewed with the Structured Clinical Interview for DSM-IV. Best-estimate DSM-IV diagnoses were formed by combining the interview and case note data. Register diagnoses were used to estimate the effect of the nonresponders.Main Outcome Measures: Diagnosis of any psychotic or bipolar I disorder according to the DSM-IV criteria.Results: The lifetime prevalence of all psychotic disorders was 3.06% and rose to 3.48% when register diagnoses of the nonresponder group were included. Lifetime prevalences were as follows: 0.87% for schizophrenia, 0.32% for schizoaffective disorder, 0.07% for schizophreniform disorder, 0.18% for delusional disorder, 0.24% for bipolar I disorder, 0.35% for major depressive disorder with psychotic features, 0.42% for substance-induced psychotic disorders, and 0.21% for psychotic disorders due to a general medical condition. The National Hospital Discharge Register was the most reliable of the screens ( kappa = 0.80). Case notes supplementing the interviews were essential for specific diagnoses of psychotic disorders.Conclusions: Multiple sources of information are essential for accurate estimation of lifetime prevalences of psychotic disorders. The use of comprehensive methods reveals that their lifetime prevalence exceeds 3%.