目的观察卒中(包括脑梗死和脑实质内出血)后3个月内卒中后抑郁(post-stroke depression,PSD)的发生率,探讨与PSD发生相关的人口学和临床危险因素。方法连续收集2008年4月至2009年12月住院的卒中患者(包括脑梗死和脑实质内出血)314例。...目的观察卒中(包括脑梗死和脑实质内出血)后3个月内卒中后抑郁(post-stroke depression,PSD)的发生率,探讨与PSD发生相关的人口学和临床危险因素。方法连续收集2008年4月至2009年12月住院的卒中患者(包括脑梗死和脑实质内出血)314例。收集患者的人口学资料及相关临床指标如美国国立卫生院神经功能缺损评分(Nationat Institute of HealthStroke Scale,NIHSS)、改良Rankin量表评分(modified Rainkin Scale,mRS)和简易精神状态检查表(minimental status examination,MMSE)评分。在发病90±7 d,使用世界卫生组织复合性国际诊断交谈3.0中文版(The World Health Organization Composite International Diagnostic Interview,WHO—CIDI 3.0)对所有患者进行访谈,按照精神疾病诊断与统计手册—Ⅳ(Diagnostic and Statistical Manual of MentalDisorders-Ⅳ,DSM-Ⅳ)的诊断标准作出抑郁的诊断。结果 PSD在卒中后3个月的累计发生率为29%(91/314),其中重性抑郁76例(24.2%),轻性抑郁15例(4.8%)。PSD组和non-PSD组之间性别、既往抑郁病史差异有统计学意义(P<0.01);PSD组发病后14 d的NIHSS、mRS和发病后90 d的mRS大于non-PSD组(P<0.01)。多因素分析结果显示:性别[比值比(Odds ratio,OB):2.178,95%可信区间(confidence interval,CI):1.219～3.892,P<0.01]、既往抑郁病史(OR:5.762,95%CI:2.958～11.223,P<0.01)、发病后14 d的残障水平(OR:1.520,95%CI:1.212～1.907,P<0.01)是与PSD发生相关的独立危险因素。结论卒中后3个月内,PSD的累积发生率为29%,说明PSD是卒中后的常见并发症,应该予以高度重视。女性、既往抑郁病史和发病后14 d的残障水平是卒中后3个月内发生抑郁的3个独立危险因素。展开更多
Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent...Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.展开更多
文摘目的观察卒中(包括脑梗死和脑实质内出血)后3个月内卒中后抑郁(post-stroke depression,PSD)的发生率,探讨与PSD发生相关的人口学和临床危险因素。方法连续收集2008年4月至2009年12月住院的卒中患者(包括脑梗死和脑实质内出血)314例。收集患者的人口学资料及相关临床指标如美国国立卫生院神经功能缺损评分(Nationat Institute of HealthStroke Scale,NIHSS)、改良Rankin量表评分(modified Rainkin Scale,mRS)和简易精神状态检查表(minimental status examination,MMSE)评分。在发病90±7 d,使用世界卫生组织复合性国际诊断交谈3.0中文版(The World Health Organization Composite International Diagnostic Interview,WHO—CIDI 3.0)对所有患者进行访谈,按照精神疾病诊断与统计手册—Ⅳ(Diagnostic and Statistical Manual of MentalDisorders-Ⅳ,DSM-Ⅳ)的诊断标准作出抑郁的诊断。结果 PSD在卒中后3个月的累计发生率为29%(91/314),其中重性抑郁76例(24.2%),轻性抑郁15例(4.8%)。PSD组和non-PSD组之间性别、既往抑郁病史差异有统计学意义(P<0.01);PSD组发病后14 d的NIHSS、mRS和发病后90 d的mRS大于non-PSD组(P<0.01)。多因素分析结果显示:性别[比值比(Odds ratio,OB):2.178,95%可信区间(confidence interval,CI):1.219～3.892,P<0.01]、既往抑郁病史(OR:5.762,95%CI:2.958～11.223,P<0.01)、发病后14 d的残障水平(OR:1.520,95%CI:1.212～1.907,P<0.01)是与PSD发生相关的独立危险因素。结论卒中后3个月内,PSD的累积发生率为29%,说明PSD是卒中后的常见并发症,应该予以高度重视。女性、既往抑郁病史和发病后14 d的残障水平是卒中后3个月内发生抑郁的3个独立危险因素。
文摘Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.
