Cross-sectional Study On The Severe Mental Disease Of Yinchuan Residents In Ningxia

Objective To grasp the epidemiological characteristics of severe mentaldisease among residents in Yinchuan City, Ningxia; To identify the treatmentseeking behaviors and influencing factors of the Yinchuan residents whocontract mental illness for the first time; To acquire Yinchuan residents’cognitive knowledge on mental health, thus provide scientific basis for thegovernment to develop policies and measurements for the prevention andtreatment of severe mental illness in the city of Yinchuan or even in the wholeregion of Ningxia, to launch community preventative treatment of severe mentalillness as well as to standardize the management of mental disabled patients.Methods The thesis is divided into three parts.The first part Current Situation Analysis of severe mental illnessamong Yinchuan residents in Ningxia From January1,2010to31December2011, an investigation team composed of medical personnel after unifiedtraining adopted a combined method of clue investigation and clusterinvestigation in each village/neighborhood committee and residential quarter tothoroughly examine all suspected mental disabled patients. The severe mental disabled patients filled out a questionnaire, and were diagnosed by experts fromNingxia Mental Health CenterThe second part Research and analysis on the initial treatment seekingbehavior of severe mental diseased patients in Yinchuan and the influencingfactors In line with the pair matched case-control study method, patients datawho had been diagnosed with severe mental illness in Yinchuan City are listedin the Excel office tool in a random order, so a list of206cases with medicaltreatment seeking behavior is generated with the method of simple randomsampling by the adoption of a random number table. The control group isdetermined according to gender, age range between±2years.The third part Investigation and analysis of the cognitive knowledge onmental health of the general public in Yinchuan. The method of stratifiedrandom sampling is used to divide the city into three administrative areas, twostreets out of each administrative area are selected using a random number table,then two communities out of each selected street are chosen, adding up to a totalof six residential communities. Target households are randomly selected fromall community households using a systematic sampling method, out of which60people are singled out using a random number table as subjects of study.Results The first part From January1,2010to December31,2011, thethorough investigation of patients with severe mental illness in Yinchuan City,Ningxia examined a total of3104patients with prevalence rate standing at1.56 ‰, out of which schizophrenia takes up2362cases with a prevalence rate of1.19‰. The difference between the prevalence of severe mental disease inurban cities and rural areas is statistically significant (χ~2=241.501p=0.000<0.05), the different age stages of severe mentaldifference wasstatistically significant (χ~2=522.581p=0.000<0.05), after standardization,patients with severe mental disease in the age of40and above are morecommon, with a prevalence of0.56‰, followed by patients in the age of30andabove with a prevalence of0.47‰. The differences in the prevalence rate ofsevere mental illness between different ethnic groups are statistically significant(χ~2=32.232P=0.000<0.05). After standardization, patients of Han ethnicity havehigher prevalence rate than other ethnic groups, the regional prevalencedifferences are statistically significant (χ~2=49.337P=0.000<0.05), afterstandardization, Xingqing District enjoys a prevalence rate that is higher thanthat of other areas.The second part The patients stricken with severe mental disease inYinchuan, Ningxia, for their initial treatment, a majority of76%chose to seektreatment at non-specialized hospitals,15.5%chose psychiatrics,8.5%turned tosuperstition and witch doctor. The chi-square test revealed that the differencesamong the affected patients’ first choice of treatment behavior bear statisticalsignificance with the differences in ethnicities,(χ~2=14.068P=0.001<0.05),marital status (χ~2=18.901p=0.006<0.05), their guardian’s knowledge of mental heath (χ~2=15.304P=0.005<0.05) and the abstaining from psychiatric treatment(χ~2=18.308P=0.000<0.05). The chi-square test also revealed that the factorsinfluencing the decision of initial medical treatment seeking behavior of patientsinclude ethnicity (χ~2=38.474P=0.000<0.05), educational level (χ~2=10.176P=0.038<0.05), occupation (χ~2=133.711P=0.00<0.05), economic status (χ~2=77.079P=0.000<0.05), the symptoms (χ~2=14.234P=0.001<0.05), distance fromhome to medical institutions (χ~2=161.956p=0.000<0.05), guardians’educational level (χ~2=15.355P=0.004<0.05), the judgment of the patients withdisease (χ~2=19.834P=0.000<0.05), knowledge of mental illness (χ~2=12.601P=0.002<0.05), and treatment seeking habits (χ~2=9.030P=0.011<0.05).Further conditional logistic regression analysis shows that the variables fallingin the regression model are ethnicity, economic status, symptoms, the patient’sinterests, the guardian’s knowledge of mental illness and the distance to medicalinstitutions.The third part The ordinary residents of Yinchuan, Ningxia enjoy amental health literacy rate of52.5%. There is significant statistical differenceamong residents of different genders (χ~2=42.164p=0.000<0.05), ages(χ~2=42.935P=0.000<0.05), educational levels (χ~2=37.194, P=0.000<0.05),occupations (χ~2=41.268P=0.000<0.05) and lengths of residency in Yinchuan(χ~2=19.221P=0.000<0.05). The distribution of accurate responses to the questionnaires shows that thequestion with the lowest accuracy rate is one asking about whether people knowanything about the annual "World Mental Health Day", to which only10%ofordinary people answered yes.The second lowest accuracy question asks whether "psychopathy” is the sameas “neuropathy” to which15%gave the correct answer. In the future, whenpromoting mental health knowledge, attention needs to be given to those withan accuracy rate lower than50%.Conclusion (1)In our future prevention and treatment of severe mentalillness, Schizophrenia is a disease that we need to focus on; The major targetpatient groups are those of Han ethnicity,40years and bove, and the key area isXingqing District of Yinchuan city, Ningxia.(2) We need to intervene with the factors influencing patients’ treatment seekingbehaviors and decisions in different ways to urge the severe mentally diseasedpatients and their guardians of Yinchuan to seek early treatment, rectify theirtreatment seeking behavior and lighten the burden on the patients, their families,and the society.(3) In our future work of mental health promotion we need to pay attention to afew key groups of people including those above60years old, those who areilliterate, and those who are unemployed, We need to base our camp with theordinary people, reach deep into the communities and poor families, broaden our means of promotion to ensure citizens of a direct exposure to knowledge, toraise their awareness of the illness prevention, and provide scientific guidancefor the public to seek appropriate medical treatment.