抑郁症患者的家庭负担和家庭功能评价

An evaluation of family burden and family function on major depression

目的评价抑郁症患者的家庭负担和家庭功能。方法采用家庭负担量表（FBS）和家庭关怀度指数问卷（APGAR），对150例符合DSM-Ⅳ诊断标准的抑郁症患者的家庭负担和家庭功能进行评定，并与248个一般家庭进行比较，从家庭的角度评价抑郁症造成的疾病负担。结果抑郁症患者FBS的家庭经济负担、家庭日常活动、家庭休闲娱乐活动、家庭成员心理健康4个因子的阳性回答率较高（分别为57．1％、51．6％、61．9％、78．6％），家庭成员生理健康、家庭关系两个因子的阳性回答率较低（分别为28．6％、39．7％）；农村患者的家庭经济负担因子评分显著高于城镇患者[（1．14±0．09）分；（0．89±0．07）分，t=2．687，P〈0．05]，而家庭成员心理健康因子评分显著低于城镇患者[（0．42±0．36）分；（0．60±0．58）分，t=3．375，P〈0．01]；患抑郁症前存在功能障碍的家庭比例与对照组比较差异无显著性（24．6％，17．3％，Х^2=0．108，P〉0．05），患病后出现功能障碍的家庭比例显著高于患病前和对照组（63．4％，24．6％，17．3％，P〈0．01）；患病后APGAR总分及各因子分均比患病前显著降低（均P〈0．01）。结论抑郁症造成严重的家庭负担和家庭功能障碍。

Objective To study the family burden and family function of major depression. Methods 150 major depressive patients who met with DSM-Ⅳ criteria were enrolled randomly and investigated. Family Burden Scale （FBS） was used to evaluate the family burden, Family APGAR Index （APGAR） was used to evaluate the family function of major depressive patients, comparing to the control group. Results Positive rate （the family proportion whose factor score no less the average score） in four factors of FBS such as family economic burden,family daily activities,family entertainment and mental health of family member were higher（57.1% ,51.6%, 61.9%, 78.6% ）. In rural patients,the factor score of family economic burden was higher than that of urban patients（ 1.14 ±0. 09 vs 0. 89 ±0. 07, t = 2.687, P 〈 0. 05 ）, and the factor score of mental health of family member was lower （0.42 ± 0.36 vs 0.60 ± 0.58, t = 3. 375, P 〈 0.01 ）. There was no significant difference between premorbid family dysfunction of major depression and control group（24.6% vs 17.3% ; Х^2 = 0. 108, P 〉 0.05 ）. Significant differences were found in family dysfunction not only between premorbid and postmorbid （ 63.4% vs 24.6%, Х^2 = 70. 045, P〈 0. 01 ） but also between postmorbid and control group（P〈 0.01 ）. The total scores and each factor score of APGAR in postmorbid were lower than premorbid （ all P 〈 0. 01 ）. Conclusion The family burden and family dysfunction of major depression were serious and multiple, which must be payed close attention and give effective intervention.