综合性医院冠心病病人抑郁/焦虑现况研究

A Cross-sectional Survey on the Prevalence of Depressive and/or Anxiety Disorder in Coronary Heart Disease Cases in General Hospitals

目的:了解综合性医院冠心病患者抑郁和/或焦虑症状患病率及既往诊治情况。方法:采用现况研究方法,于2004年6月1日到12月1日在北京、上海、广州和成都的7家综合性医院的心内科连续收集确诊的冠心病患者359例。由经培训的调查员用统一的调查表进行面对面调查,同时使用综合医院焦虑抑郁量表(HAD)、Hamilton焦虑量表和Hamilton抑郁量表进行心理测评。结果:冠心病患者的抑郁症状、焦虑症状、抑郁合并焦虑症状以及合计的抑郁和/或焦虑症状患病率分别为19.8%,16.7%,13.6%和22.8%;在具有抑郁和/或焦虑症状的非首诊患者中,冠心病患者既往被诊断为抑郁和/或焦虑障碍和接受抗抑郁和/或焦虑治疗的比例均低于4%;住院患者在本次住院期间的抑郁焦虑诊治率低于1%。结论:综合医院冠心病病人具有较高的抑郁和/或焦虑症状和抑郁和/或焦虑障碍患病率,且既往诊治率较低。

Objective： To describe the prevalence of depressive and/or anxiety symptom and disorder in patients with coronary heart disease（CHD） in the general hospitals. Methods： A hospital-based cross-sectional study was conducted in four main cities in China in 2004. 359 eligible subjects with CHD were recruited from the outpatient or inpatient departments within six months. Face-to-face interviews were used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with HAMA scales and HAMD scales by the licensed psychologists or psychiatrists. Results： The prevalence of depressive symptoms, anxiety symptoms, depressive and anxiety symptoms, and total depressive and/or anxiety symptoms were 19.8%, 16.7%, 13.6% and 22.8% respectively in patients with CHD. Less than 4% of the subjects had been diagnosed or treated for the depressive or anxiety disorders prior to the investigation. In inpatients, the diagnosis and treatment rate was low to less than 1% during the current admission. Conclusion： It was noticeable to health care providers and health policy makers that there was high prevalence of depressive and/or anxiety symptoms and depressive and/or anxiety disorders, and low percentages of previous diagnosis and treatment in patients with CHD in general hospitals.