关键词: 精神障碍, 疾病管理, 诊断, 湖南

Abstract: Objective　To investigate the diagnostic reliability of the Central Government Support for the Local Management and Treatment of Severe Mental Illnesses Project（686 Project） for severe mental disorders patients aged 15 or over in Hunan Province. Methods　This epidemiological survey of severe mental disorders was carried out between February and June 2015. By use of multistage stratified cluster sampling，72 999 permanent community-dwelling residents aged 15 or over were recruited from 123 counties/districts of Hunan Province and 720 of them were found with severe mental disorders. The diagnostic results of such populations by the 686 Project were collected from the Internet-based information system of the project. The epidemiological results were used as the gold standard for evaluating the diagnostic reliability of the 686 Project. Results　Of the 720 patients with severe mental disorders found by the survey，349（48.5%） were under the management of the 686 Project，345 of them were registered as severe mental disorders in the 686 Project，so the diagnostic rate by the project was 47.9%（345/720）. The overall diagnostic consistency rate between the 686 Project and the survey was 39.4%（284/720）. The diagnostic consistency rates of schizophrenia，paranoid psychosis，bipolar disorder，schizophrenic psychosis，mental disorder caused by epilepsy and mental retardation with mental disorder were 50.6%（273/539），0，2.7%（2/75），12.5%（1/8），16.7%（4/24） and 6.2%（4/64），respectively. The diagnostic consistency rates of severe mental disorders between the survey and the 686 Project showed no significant differences across different counties/districts（χ2=16.83，P=0.21）. Conclusion　The diagnostic consistency rates of severe mental disorders between the survey and the 686 Project demonstrated no obvious differences between different counties/districts in Hunan Province. The rate of such patients under the management by the 686 Project and the diagnostic reliability of this project carried out in Hunan need to be improved further.

Key words: Mental disorders, Disease management, Diagnosis, Hunan