不同级别综合医院内科门诊抑郁障碍的患病率

A comparing study to the prevalence of depression of internal outpatient departments in different levels of general hospitals

目的了解沈阳市不同级别综合医院内科门诊抑郁障碍的患病率。方法采用分层随机整群抽样方法抽取沈阳市三个等级的23家综合医院进行调查，共调查5750例年龄15岁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。结果一级综合医院内科门诊任何抑郁障碍患病率（13．1％，95％CI：10．6％～16．2％）高于二级医院（10．4％，95％CI：8．4％～12．0％）和三级医院（11．2％，95％CI：9．9％～12．8％）；重性抑郁障碍患病率三级医院（4．1％，3．3％～5．1％）显著高于二级（2．7％，2．1％～3．6％）。结论一级综合医院各种抑郁障碍总患病率最高，三级医院重性抑郁障碍患病率最高。应该重点关注初级医院、三级医院抑郁障碍的诊治工作。

Objective To describe the prevalence of depression of internal outpatient departments in three 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 investigation, a total 5750 outpatients above 15 years of age in outpatient departments have been investigated. The expanded version of General Health Questionnaire（GHQ-12） was used 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 prevalence of any depression disorder of level one hospitals （ 13.1% ,95% CI： 10.6% - 16.2%） was higher than the prevalence of level two （ 10.4% ,95% CI：8.4% - 12.0% ） and level three （ 11.2% ,95% CI：9.9% - 12.8% ）. The prevalence of major depression of level three hospitals （4. 1%, 95 % CI：3.3 % - 5.1% ） was distinctly higher than the prevalence of level two hospitals （2.7% ,95CI% ：2.1% -3.6% ） . Conclusion The prevalence of any depression of level one general hospitals was highest. The prevalence of major depression of level three general hospitals was highest. It is important to pay attention to the diagnosis and treatment of depression of primary and tertiary hospitals.