综合医院内科门诊抑郁障碍患病率及特征

The prevalence and features of depression of internal outpatient departments in general hospitals

目的 了解中国沈阳市各级综合医院内科门诊抑郁障碍的患病率,为提高综合医院抑郁障碍的诊治水平提供基础数据。方法 采用分层随机整群抽样方法抽取沈阳市23家综合医院进行调查,共调查5750例年龄15岁及以上的内科门诊病人。调查员在病人就医内科医生前使用扩展的一般健康问卷（GHQ-12）作为筛查工具,将调查样本分为精神疾病高、中、低危险组,然后由精神科医生使用DSM-Ⅳ定式临床检查（SCID-I/P）对筛选高、中、低危险组100%、40%、10%的调查对象进行SCID诊断。结果 沈阳市综合医院任何抑郁障碍的总现患率为11.0%（95%CI为10.1%～12.1%）、重性抑郁障碍、心境恶劣障碍、未特定抑郁障碍患病率分别为3.6%（3.1%～4.2%）、2.8%（2.4%～3.4%）、4.1%（3.5%～4.8%）。抑郁障碍者以年龄大、丧偶、女性多,同时文盲、低收入者、无业者为多。特别的是,抑郁障碍者中有信仰者居多。结论 沈阳市综合医院内科门诊抑郁障碍患者患病率较高,与发达国家综合医院抑郁障碍患病率相近。综合医院内科应该关注具有抑郁障碍特征的人群。

Objective To describe the prevalence of depression of internal outpatient departments in different levels of general hospitals in Shenyang,and provide the basic data for improving diagnosis and treatment capacity for depression disorders. Methods Stratified multi-stage cluster randomization was used to identify 23 general hospitals for investigation, a total 5750 outpatients above 15 years of age in internal outpatient departments have been investigated . Investigator used expanded version of General Health Questionnaire（GHQ-12） as a screen instrument to identify subgroups of the sample at high , moderate and low risk, then psychiatrists determined their diagnosis by using structured clinical interview for DSM-IV Axis I Disorders-Patient Edition（SCID-I/P） for 100% of high-risk and 40% of moderate-risk and 10% of low-risk subjects. Results The overall current rate of any de- pression disorders was 11.0% （95% CI ： 10.1% - 12.1% ）, major depression, dysthymia, not otherwise specified depression disorders respectively was 3.6% （ 3.1% - 4.2% ） ,2.8% （ 2.4% - 3.4% ）, 4.1% （ 3.5% - 4.8% ） of Shenyang general hospitals. Of the depression patients, old age, female, loss of spouse and out of work were the highest numbers, follow by illiterate and low income patients. Especially, there were some religious patients in de- pression. Conclusion The prevalence of depression of internal outpatient departments of general hospitals was higher and closer to the developed countries. The depressive patients group should be cared by the physicians of internal departments in general hospitals.