Prevalence of psychiatric morbidity in the adult population of a rural South African village
Prevalence of psychiatric morbidity in the adult population of a rural South African village
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DOI：
10.1017/s0033291700035327
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发表时间：
1996-09-01
影响因子：
6.9
通讯作者：
Zwarenstein, M
中科院分区：
文献类型：
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作者：
Rumble, S;Swartz, L;Zwarenstein, M
我们报告了南非首个两阶段社区精神疾病患病率研究，该研究是在距离开普敦50公里的农村“有色人种”村庄Mamre进行的。对随机抽取的481名成人(N=481)进行自我报告问卷(SRQ)作为第一阶段筛选，并对部分样本(N=121)进行现况调查(PSE-9)作为第二阶段标准。还收集了人口统计、医疗保健利用和药物滥用数据。使用定义为5的PSE-9 CATEGO指数，精神疾病的加权患病率为27.1%(可信区间为19.5-34.7%)，大多数病例被初步诊断为抑郁或焦虑障碍。CATEGO算法在这种文化背景下可能并不完全合适，因为对偏执状态有明显的过度诊断。SRQ的加权敏感度为0.49，特异度为0.82。总体而言，SRQ正确识别了67%的病例和非病例。没有人口统计学变量预测精神病发病率，但发病率和初级保健利用之间存在间接联系。南非需要进一步研究SRQ和标准文书的有效性。这些可能有助于了解影响精神病学诊断的文化因素。
We report on the first South African two-stage community prevalence study of psychiatric morbidity, conducted in Mamre, a rural 'coloured'(2) village, 50 km from Cape Town. Randomly selected adults (N = 481) were assessed using the Self-Reporting Questionnaire (SRQ) as a first-stage screen and the Present State Examination (PSE-9) was administered to a proportion of the sample (N = 121) as the second-stage criterion. Demographic, health care utilization, and substance abuse data were also collected. Using the PSE-9 CATEGO Index of Definition of 5, the weighted prevalence of psychiatric morbidity was 27.1% (confidence interval of 19.5-34.7%), the majority of cases being given a tentative diagnosis of depressive or anxiety disorder. The CATEGO algorithm may not be fully appropriate in this cultural context as there was an apparent overdiagnosis of paranoid states. The SRQ's weighted sensitivity and specificity were 0.49 and 0.82 respectively. Overall, the SRQ correctly identified 67% of cases and non-cases. No demographic variables predicted psychiatric morbidity, but there was an indirect link between morbidity and primary care utilization. Further South African studies of the validity of both the SRQ and of criterion instruments are needed. These may contribute to knowledge regarding cultural factors affecting psychiatric diagnosis.