| Background With the rapid development and intense competition ofsociety, there has been an increasing tendency of neurotic disorders. Neuroticdisorders have become one of the most common mental disorders. In ourcountry, the patients with neurotic disorders rarely go to psychiatry departmentand they frequently go to general hospitals, which not only lead to delaydiagnosis and treatment, but also aggravate patients economic burden. Theprevious epidemiological studies on neurotic disorders mainly focus oncommunity population and students. Most of the studies were about the ways ofhelp-seeking of patients. There were few studies on the prevalence anddistribution characteristics of neurotic disorders in non-psychiatry clinics. Xi’anis the provincial capital city of Shaanxi province and the centre of northwest of China, where converged many patients from all over the country. Consequently,it is very important to make an early diagnosis and give right treatment ofneurotic disorders for doctors and nurses in general hospitals.Objective①To explore the prevalence, related factors, and distributingcharacteristic of neurotic disorders in non-psychiatry outpatients of Xi’angeneral hospitals;②To obtain outpatients, nurses and doctors’ knowledge,attitude and practice (KAP) about neurosis in general hospitals and provide thescientific evidences for early identification and effective interventions ofneurotic disorders.Methods Three general hospitals were conveniently selected fromthree-ranked general hospitals in Xi’an. The prevalence of neurotic disordersamong outpatients was assessed by World Health Organization CompositeInternational Diagnostic Interview Version3.0(CIDI-3.0) according to theInternational Classification of Disease10thRevision (ICD-10) criteria andoutpatients, nurses and doctors were surveyed by Investigation Questionnaire onthe knowledge，attitude and behavior scale. The survey was conducted throughJune2010to December2010. The SPSS statistics software package (version17.0) was used for all data analysis. Simple cross-tabulations were used tocalculate prevalence. Associations with socio-demographics and related factorswere examined using multivariate unconditional multinomial logistic regressionanalysis. The significance of comparison of rates was assessed with2tests.For each odds ratio (OR), the95%confidence interval (CI) was calculated.Statistical significance was based on two-tailed tests evaluated at the0.05levelof significance.Results 1. The epidemiological characteristic of neurotic disorders in generalhospital outpatientsThere were40patients (10.75%) diagnosed as neurotic disorders amongoutpatients in Xi’an general hospitals. The prevance of social phobia, specificphobia, panic disorders, obsessive-compulsive disorders, general anxietydisorders and agoraphobia was1.34%,5.65%,1.08%,3.76%,0and0.81%,respectively.Multivariate unconditional logistic regression analysis showed that the ageless than40years old (OR=4.442,95%CI=2.050～9.624), visiting department ofinternal medicine (OR=6.545,95%CI=1.509～28.383), education backgroundless than6years (OR=4.189,95%CI=1.792～9.790), female(OR=2.253,95%CI=1.136～4.469) were related factors of neurotic disorders.2. Knowledge, attitude and practice of outpatients, nurses and doctors ingeneral hospitalsMore than70%doctors heard of generalized anxiety disorders, obsessivecompulsive disorders, social anxiety disorders and panic disorders.45.6%~69.0%doctors could enumerate some clinical manifestations of neurosis.The percentage of doctors making accurate diagnosis, treatment and listingtherapeutic drug accounted for37.7%,32.1%and41.0%, respectively. Theknowledge of neurosis among doctors in third-level general hospital was higherthan that of first and second-level general hospitals (P＜0.01).The knowledge of neurosis among nurses in general hospitals was at variouslevels. It showed the rising trend with the hospital grade rising. Nearly90.0%nurses thought patients with neurosis would do harm to themselves and the otherpeople thought if their behavior lost of control.94.4%nurses believed that neurosis might lead to schizophrenia. More than70%nurses heard of neurosis.There was no significant difference of the common knowledge of neurosisamong three-ranked hospitals (P＞0.05). The theraputical knowledge ofneurosis had significant difference among three-ranked hospitals (P＜0.05).The knowledge of neurosis among outpatients in general hospitals was atlow level.24.2%of patients knew about main clinical manifestations of neurosis.The percentage of outpatients who believed that neurosis could be treated bydrugs and psychiatry was32.3%and33.6%, repectively. If outpatients sufferedneurosis,44.4%of them were willing to see psychiatrist and24.2%preferred tovisit neurology department of general hospitals. There was significantlystatistical difference of help-seeking among three-ranked general hospitals (P＜0.05).45.2%of outpatients were willing to know about related knowledge ofneurosis.30%of them wanted to examine wether they suffered neurosis or not.46.5%of them thought they would urge those with manifestations of neurosisaround them to go to see a doctor.Most doctors and nurses acquired knowledge of neurosis through broadcast,TV or video, newspaper and magazines. There was an increasing tendency withthe ranking of hospital increased. Outpatients acquired knowledge of neuros ismainly through broadcast, TV, video and their friends or relativtes.ConclusionsThe prevalence of neurotic disorders among outpatients in general hospitalsof Xi’an was10.75%, which is at high level. Internal medical clinics, under40years old, female and less than6years education were associated with neuroticdisorders.The knowledge of neurosis among outpatients, doctors and nurses in general hospitals of Xi’an was at low level. It is very necessary to enhance outpatients,doctors and nurses understanding on neurosis through broadcast, TV, video,newspaper and magazine. |
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