综合医院门诊病人焦虑、抑郁与躯体症状的关联研究

Relationship Between Anxiety,Depression and Somatic Symptoms in Outpatients in General Hospitals

目的:探讨广州地区综合医院门诊就诊者的焦虑、抑郁症状及与躯体症状的关系。方法:通过随机抽样从广州市卫生局抽取广州15家综合医院,采用医院焦虑抑郁量表(HADS)和病人健康问卷(PHQ-15)对1842例综合医院普通门诊就诊者进行量表评定。结果:1842例门诊病人中,焦虑、抑郁及焦虑、抑郁合并现患率分别为14.0%、10.2%、17.8%;躯体症状与焦虑、抑郁的相关分析显示,PHQ-15总分、PHQ-15阳性症状数目与HADS总分、HAD-A因子分及HAD-D因子分呈显著正相关;以躯体症状轻微(PHQ-15,0-4分)组作为参考值,计算不同程度躯体症状患者焦虑、抑郁患病相对危险度,结果显示,轻度(PHQ-15,5-9分)、中度(PHQ-15,10-14分)、重度(PHQ-15,15-30分)躯体症状患者焦虑患病的相对危险度RR(95%CI)分别为2.90(1.94-4.33)、8.32(5.40-12.81)、23.05(12.72-41.77);抑郁患病的相对危险度RR(95%CI)分别为2.37(1.52-3.68)、6.98(4.38-11.13)、9.86(5.18-18.77);焦虑、抑郁合并患病的相对危险度RR(95%CI)分别为2.80(1.98-3.96)、8.11(5.53-11.89)、18.12(10.26-32..03)。结论:综合医院门诊就诊者焦虑、抑郁常见;躯体症状与焦虑、抑郁密切相关,躯体症状程度越重,躯体症状数目越多,焦虑、抑郁越明显,焦虑、抑郁患病相对危险度越高。

Objective： To investigate the prevalence of anxiety and depressive symptoms and to analyse the relationship between anxiety, depression and somatic symptoms in outpatients in general hospitals. Methods： By way of a cross- sectional survey, 1842 outpatients from 15 general hospitals in Guangzhou, China,were tested with Hospital Anxiety and Depression Scale （HADS） and Patient Health Questionnaire （PHQ-15）. Results： The prevalence rates of anxiety and/or depressive symptoms were 14.0%, 17.8%,10.2% respectively in outpatients in Guangzhou. Significant correction was observed between HADS and PHQ-15 scores （r 0.374-0.481 ,P〈O.01）. Compared with patients with minimal somatic symptom severity（PHQ-15 scores=O-4）, the Relative Risk （RR）（95%CI） for anxiety and/or depression in patients with low PHQ-15 scores（5-9） were 2.90（1.94-4.33）,2.80（1.98-3.96）,2.37（1.52-3.68） respectively; in patients with medium PHQ- 15 scores（10-14） were 8.32（5.40-12.81）,8.11（5.53-11.89）,6.98（4.38-11.13） respectively; in patients with high PHQ-15 scores（15-30） were 23.05（12.72-41.77）,18.12（10.26-32.03）,9.86（5.18-18.77） respectively. Conclusion： There is high prevalence of anxiety and/or depression in outpatients in general hospitals. Also significant correlation was observed between anxiety, depression and somatic symptoms.