[A multilevel cross-sectional study of mental disorder in community settings in Zhejiang Province].

OBJECTIVE: To investigate the prevalence of mental disorder through the 12-item general health questionnaire (GHQ-12) survey and its related factors in community settings in Zhejiang Province. METHODS: A muti-level model was analyzed using data of 14,632 respondents nested in counties (cities), townships (urban districts), villages (urban neighborhoods) from the epidemiological survey of mental illnesses above 15 years old. RESULTS: The mean score measured by GHQ-12 was (1.54 +/- 2.15), which was lower than that of samples from four cities of Guangzhou, Chongqing, Taiyuan and Hangzhou (U = 11.08, P < 0.01). The mental disorder clustered within county (city) level, which represented 4.3% (chi(2) = 3.94, P < 0.05) of the total variance including four levels. After controlling for the county level, the mental disorder was associated with age, marital status, residency patterns, education, occupation and household incoming. In particular, it was reported that higher household incoming was significantly associated with better mental disorder among population in community settings. CONCLUSION: The prevalence of mental disorder clustered at the county (city) level is relatively lower with vulnerable groups including divorced, widowed, unemployed, retired, lower-income ones in community settings in Zhejiang Province.

[Epidemiological survey of mental illnesses in the people aged 15 and older in Zhejiang Province, China].

OBJECTIVE: To describe the current prevalence and distribution of all types of mental disorders in Zhejiang Province and use this data to develop a provincial mental health plan. METHODS: Stratified multi-stage cluster randomization was used to identify 14 counties (cities), 70 townships (urban districts), 140 villages (urban neighborhoods) and 15,000 subjects > or = 15 years of age. Psychiatric nurses used an expanded version of the General Health Questionnaire (GHQ) to identify subgroups of subjects at high, moderate and low risk of having a mental disorder, then psychiatrists determined their diagnoses by administering a structured psychiatric examination (SCID) that employs American diagnostic criteria for mental disorders (DSM-IV) to 100% of high-risk, 40% of moderate-risk and 10% of low-risk subjects. RESULTS: 14 639 subjects completed the screening and 4,788 completed the psychiatric examination. The adjusted overall current rate of mental disorders was 17.3% (95% CI = 16.0%-18.7%), which dropped to 13.4% (12.2%-14.7%) if the non-specific (NOS) disorders were excluded. The most common diagnostic groups were affective disorders (8.6%, 7.9%-9.5%), anxiety disorders (4.3%, 3.6%-5.1%), and substance use disorders (3.0%, 2.4%-3.8%). The most common specific disorders were major depressive disorder (4.3%, 3.7%-4.9%), alcohol use disorder (2.9%, 2.3%-3.7%), dysthymia (1.6%, 1.3%-1.9%) and specific phobias (1.2%, 0.8%-1.8%). The overall prevalence was higher in rural than in urban areas (RR = 1.23, 95% CI = 1.11-1.37) and slightly higher in women than in men (RR = 1.11, 1.00-1.22). CONCLUSIONS: Mental disorders seriously affect the social and economic development of Zhejiang Province; they are a major public health problem that urgently needs to be addressed. To do this, it is necessary to develop and implement a comprehensive province-wide mental health plan and regularly evaluate its effectiveness.

[Levels of common knowledge on common psychiatric disorders and therapeutic means taken in general population: effects of education level and living area].

OBJECTIVE: To investigate the differences in level of common knowledge toward common psychiatric disorders and means of therapy in general population, resulting from different education levels and living areas. METHODS: All 4,614 persons over 15 years of age recruited from general population in Zhejiang Province via stratified randomly sampling, were classified by education levels as illiteracy, primary school level, high school level, and college level. Each group was thus divided into two categories according to the person's living areas, ie urban and rural area. The level of common knowledge about psychosis and means of therapy were measured by a questionnaire administered to all subjects. RESULTS: The rate of knowledge of neurasthenic was the highest, reaching to 71.1%, then of knowledge of schizophrenia and depression, was 47.9% and 39.3% respectively, and the rate of knowledge of alcohol dependence, mania and obsessive-compulsive disorder was lower than 20%. The rate of knowledge of the 6 common psychiatric disorders was higher in people from urban area, than from rural areas. The rate of knowledge of common psychiatric disorders was increased correspondingly to the increase of the education level among the people residing at the same living area. The main means of therapy the people selected was western medicine and psychology, reaching at 24.0% and 34.8% respectively. There were significant differences among the people with different education levels but from the same living areas, and the people with lower education levels were likely to choose the therapy of western medicine, on the other hand, the people with higher education levels were tending to choose the therapy of psychology. CONCLUSION: The popularization of the knowledge and the education about mental health should be reinforced, as to improving the knowledge about mental health, choosing a correct means of therapy to the common psychiatric disorders and promoting the mental health status of the population.