台灣慢性精神障礙盛行率長期變化趨勢分析：2000-2014年

Long-term Prevalence Trend Analyses of Taiwanese Chronic Mental Disability based on Governmental Disability Register

慢性精神障礙群體在醫療衛生與社會福利之權益保障是一項公共衛生重要議題。慢性精神障礙者不僅社交功能退化，與他人的交流受到了限制，同時職業方面的弱勢，需要在他人庇護的狀況下，維持其部分工作能力；瞭解慢性精神障礙人口學特性是公共衛生政策的首要基礎。為了瞭解並描述台灣地區慢性精神疾病在性別、年齡及障礙等級的長期趨勢，本研究以我國2000年至2014年衛生福利部統計處身心障礙者人口資料庫及內政部公布的人口年齡分布為基礎，進行長期盛行率趨勢分析，以線性回歸進行趨勢檢定。結果顯示台灣地區慢性精神障礙全人口盛行率隨著年代顯著增加。慢性精神障礙盛行率以年齡層分層分析，發現在12-14歲、18-29歲、30-44歲、45-59歲、60-64歲、65歲以上顯著隨年代增加，而慢性精神障礙者多集中在30-44歲及45-59歲。在障礙等級分析中，研究發現重度、中度及輕度三類都有顯著增加趨勢，尤其是中度障礙者，增加幅度最高。在地區分布部分，台灣北中南東四區的慢性精神障礙者盛行率都隨著年代顯著增加，而在北區部分盛行率最高，上升趨勢較陡，東區部分盛行率則最低，上升趨勢較緩。目前台灣地區慢性精神障礙盛行率逐年增加，尤其以30-59歲勞動人口盛行率最高，並且有城鄉差距的生活壓力因素，導致城市居民慢性精神疾病盛行率最高，且上升幅度大。因此，政府和社福單位必須重視民眾心理照護服務，預防民眾罹患慢性精神疾病，避免慢性精神疾病罹患率持續增加。

Protecting human rights in medical and social welfare for people with chronic mental illness is an important public health issue. People with chronic mental illness not only have problems in social functioning which limits their social interaction with others, but also become vulnerable population in workplaces and need assistances to enable them to participate in workforce. Understanding characteristics of the population with chronic mental illness is momentous to develop public health policies and helps the government make more informed decisions. The purpose of this study is to observe the long-term prevalence changes among people with chronic mental illness during 2000-2014 in Taiwan by analyzing the handicapped population-based database which is established and collected by Taiwan Ministry of Health and Welfare. By analyzing the database, the study found that the prevalence of chronic mental illness significantly increased yearly. Based on age stratified analysis, it turned out that the prevalence significantly increased yearly among 12-14-year-old (p=0.027), 18-29-year-old (p=0.003), 30-44-year-old (p=0.001), 45-59-year-old (p<0.001), 60-64-year-old (p<0.001), and older than 65-year-old (p<0.001). And the high prevalence of chronic mental illness is among 30-44-year-old and 45-59-year-old. Based on level of disability stratification analysis, the prevalence of mild, moderate, and severe disability level significantly increased yearly, especially in the prevalence of moderate disability has a significant increase. Based on administrative districts stratification analysis, the disability prevalence of all area significantly increased yearly, and the prevalence of north area is the highest among all areas. In the meanwhile, the prevalence of east area is the lowest of all area and increased slowly comparing with other areas.