综合医院心内科门诊患者抑郁和焦虑障碍患病率调查

Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities

目的 调查中国5城市（北京、上海、广州、成都、长沙）综合医院心内科门诊患者抑郁障碍和焦虑障碍的患病率.方法 本研究为以医院为基础的横断面调查,患者来自5个城市共14家三级甲等综合医院的心内科门诊.以指定调查日内年龄≥18岁、意识清楚、能独立回答问题并知情同意的就诊者为调查对象,顺序纳入.患者完成一般问卷、医院焦虑抑郁量表（HADS）的自评筛查;就诊科室医生在不了解筛查结果的情况下独立完成诊疗;由经过一致性培训的精神科医师对HADS≥8分的患者进行国际神经精神科简式访谈问卷（MINI）的诊断性评估.知情同意并完成筛查但拒绝MINI检查者按失访处理.结果 完成调查的患者2 123例.（1）经失访校正后现患总患病率：抑郁和焦虑4.05％ （86/2 123）,抑郁或焦虑14.27％ （303/2 123）,抑郁或焦虑或混合抑郁焦虑14.37％ （305/2 123）.（2）经失访校正后的终生总患病率：抑郁和焦虑5.37％（114/2 123）,抑郁或焦虑16.91％（359/2 123）,抑郁或焦虑或混合抑郁焦虑17.00％（361/2 123）.结论 综合医院心内科门诊患者焦虑、抑郁患病率高,应注意对抑郁焦虑的识别诊断.

Objective To explore the prevalence of depression and （or） anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities.Methods A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities.The patients aged 18 years and over were recruited consecutively,who were conscious and with informed consent,and can finish the questionnaire independently.All the subjects were screened with Hospital Anxiety Depression Scale （HADS）.The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview （MINI）.The physicians made the diagnosis and management without knowing the results of MINI and HADS score.Subjects who refused MINI were defined as the case of loss of follow-up.Results A total 2 123 subjects were included in the survey.The adjusted prevalence rate of depressive and anxiety disorder was 4.05％ （86/2123）,the depressive and/or anxiety disorder was 14.27 ％ （303/2 123）,depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37％ （305/2 123） according to MINI.The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37％ （114/2 123）,depressive and/or anxiety disorder was 16.91％ （359/2 123）,depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00％ （361/2 123）.Conclusion There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China.Therefore,doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.