综合医院中医科门诊抑郁障碍患病率

The prevalence of depression of China traditional medicine outpatient departments in different levels of general hospitals

目的 了解沈阳市三个级别综合医院中医科门诊抑郁障碍的患病率,并进行比较。方法 采用分层随机整群抽样方法共抽取沈阳市23家三个级别综合医院进行调查,共调查1698例年龄15岁以上的中医科门诊病人。调查员在病人就医中医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 沈阳市综合医院中医科门诊各种抑郁障碍总患病率为16.2%（95%CI：13.2%～19.9%）;一级医院任何抑郁障碍患病率（19.1%,95%CI：10.1%～36.0%）高于三级医院抑郁障碍患病率（17.5%,95%CI：14.5%～21.1%）和二级医院（9.1%,95%CI：4.0%～21.7%）;重性抑郁障碍患病率三级医院（8.3%,6.6%～10.5%）显著高于一级医院（6.0%,1.9%～19.1%）和二级医院（1.5%,0.6%～4.0%）。结论 沈阳市综合医院中医科门诊抑郁障碍患病率较高,一级医院最高。应该加强初级医院中医科门诊抑郁障碍的防治工作。

Objective To describe the prevalence of depression of China traditional medicine outpatient departments in different levels of general hospitals in Shenyang and to compare, to the prevalence of the three levels （level one ,level two and level three） of general hospitals. Methods Stratified multi-stage cluster randomization was used to identify 23 general hospitals for investigauon,and a total 1698 China traditional medicine outpatients above 15 years of age in outpatient departments have been investigated. The researcher 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 In China traditional medicine outpatient departments, the prevalence of any depression disorder was 16.2% （95% CI： 13.2% - 19.9% ） ; the prevalence of level one （ 19. 1% ,95% CI： 10. 1% - 36.0% ） was higherthan level three（17.5%,95% CI：14.5% -21. 1%） and level two （9. 1%,95% CI：4.0% 21.7% ） ; the prevalence of major depression of level three hospitals（ 8.3% ,6.6% - 10.5% ） was distinctly higher than the prevalence of level one hospitals（6.0% , 1.9% - 19.1% ） and level two hospitals（ 1.5% ,0.6% 4.0% ）. Condusion The prevalence of depression in general hospitals in Chilm traditional medicine was high, and level one hospital was highest. It is important to pay attention to the diagnosis and treatment of depression of primary hospitals in China traditional medicine outpatient departments.