精神分裂症患者与焦虑障碍共病发病率调查:194例特征

Investigation on incidence of comorbidity of schizophrenia and anxiety disorder: Characteristics of 194 cases

目的:分析精神分裂症患者与焦虑障碍共病的发生率及其相关因素。方法:随机选取2003-10/2004-06在山东省精神卫生中心住院的194例精神分裂症患者为观察对象,全部患者均符合中国精神障碍分类与诊断标准第三版精神分裂症诊断标准,其中男99例,女95例。采用一般情况调查表调查患者的一般情况家庭经济状况、家庭关系,住院时间等。采用焦虑自评量表评定患者的焦虑程度,包括20个项目,采用4级评分(1-4),界定值50分,得分越高,提示焦虑越严重。采用简明精神病评定量表评定患者精神病症状的严重程度,包括量表总分及其焦虑抑郁、思维障碍、缺乏活力等因子,采用7级评分(1～7),总分越高,提示疾病越严重。采用副反应量表评定药物副反应的严重程度,包括行为毒性、化验异常、其他项目异常等因子,采用5级评分(0～4),得分越高,表明副反应越严重。主要观察精神分裂症患者与焦虑障碍的共病率及相关影响因素,组间比较采用χ2检验、t检验、相关分析和多元逐步回归分析。结果:所调查的194例精神分裂症患者全部进入结果分析。①住院精神分裂平患者与焦虑障碍的共病率及其相关因素:本次调查焦虑自评量表平均分≥50分的患者21例,精神分裂症与焦虑障碍的共病率为12%,焦虑障碍的发生与住院时间呈显著负相关(r=-0.24,P<0.01),与简明精神病评定量表总分及其焦虑抑郁、思维障碍因子呈显著正相关(r=0.15～0.68,P<0.01～0.05),与副反应量表及其化验异常、其他项目异常同样呈正相关(r=0.14～0.20,P<0.01～0.05)。②精神分列症共病焦虑障碍相关因素的多元逐步回归分析:多元逐步回归分析结果显示,焦虑障碍的发生与住院时间、安坦、药物副反应、氯硝安定密切相关。结论:焦虑症状在精神分裂症患者中较为常见,焦虑障碍的发生除与本身病情有关外,住院时间及药物的毒性及副反应也是很重要的因素,应引起医护人员的高度重视。

AIM： To analyze the incidence of comorbidity of schizophrenia and anxiety disorder with the related factors. METHODS： 194 inpatients, who were treated at the Shandong Provincial Mental Health Center from October 2003 to June 2004, were selected randomly as observation objects. All the patients were accorded with the criteria of CCMD-3 for schizophrenia, including 99 males and 95 females. General condition scale was used to assess family economical state,family relationship, hospitalization time,etc. Anxiety level was assessed with Self-rating Anxiety Scale （SAS） composed of 20 items, uning 4-grade score with the 50 points evaluating value,and the higher score indicated the severe anxiety.Mental symptoms were evaluated with Brief Psychiatric Rating Scale,composed of total score of scale, anxiety-depression,thinking disturbance, lacking of activity, etc., and every item was rated with 7-grade score （1-7）. The high score indicated the severe disease.Side effects were evaluated with Treatment Emergent Symptom Scale （TESS）composed of behavior toxicity, laboratory abnormality, abnormity of other items, etc. and every item was rated by 5-grade score （0-4）. The high score indicated the severe side effects. Comorbidity of schizophrenia and anxiety disorder with its related factors was observed mainly. All data were analyzed with χ^2-test, t-test, correlation analysis and multiple stepwise regression analysis. RESULTS： Totally 194 patients with schizophrenia were involved in the result analysis, ① Comorbidity rate of schizophrenia and anxiety disorder and its related factors in inpatients： Twenty-one patients had at least 50 points averagely in the SAS, and the comorbidity rate of schizophrenia and anxiety disorder was 12%. The occurrence of anxiety disorder had significant negative correlation with length of stay （r=-0.24, P〈0.01）, had significantly positive correlation with total score of Brief Psychiatric Rating Scale and factor scores of anxiety depression, thought disorder（r=-0.15-0.68, P〈0.01-0.05）, had positive correlation with laboratory abnormality and other abnormal items （r=0.14-0,20, P〈0.01-0.05）. ② The results of multiple stepwise regression analysis of related factors of comorbidity of schizophrenia and anxiety disorder： The results of multiple stepwise regression analysis showed that occurrence of anxiety disorder were closely related to hospitalization time, artane, adverse effects of drugs and clonazepam. CONCLUSION： Anxiety symptoms are common in patients with schizophrenia. The occurrence of anxiety disorder should be attracted more attention, with related to hospitalization time, toxicity and adverse effects of drugs besides the state of an illness.