综合医院就诊者中抑郁焦虑障碍的患病率调查

A cross-sectional survey of the prevalence of depressive.anxiety disorders among general hospital outpatients in five cities in China

目的了解综合性医疗机构中门诊就诊者抑郁和焦虑障碍的患病率。方法采用多中心、大样本、横断面设计，调查8487例综合医院门诊就诊者。采用医院焦虑抑郁量表（HADS）和患者健康状况量表（PHQ-15）筛查，阳性者做国际神经精神科简式访谈问卷（MINI）诊断评估。结果MINI诊断的抑郁障碍、焦虑障碍、抑郁和焦虑共病的校正患病率分别为12．0％、8．6％和4．1％，有其中任一诊断的患病率为16．5％。不同科室就诊者中的患病率存在差异。结论抑郁和焦虑障碍是综合医院就诊者中的常见问题，但正确识别和治疗情况不容乐观。

Objectives To find the prevalence of depressive and anxiety disorders among general hospital outpatients and to evaluate the diagnoses and treatment provided by physicians in China. Methods A multi-center, hospital-based cross-sectional study was conducted. A total of 8478 subjects were screened by using HADS and PHQ-15 together with medical history review list and were followed by regular clinical visit process. Physician＇s diagnoses and management were recorded. Mini International Neuropsychiatric Interview （MINI） was used to evaluate by psychiatrists afterwards for 4172 subjects scored 28 on HADS. Results The adjusted prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, depression and anxiety, depression or anxiety disorders were 12.0% , 8.6% , 4. 1% and 16. 5% , respectively. The prevalence of depressive and/or anxiety disorder in outpatients visiting department of neurology and digestive diseases were higher than that in patients visiting departments of cardiovascular diseases and gynecology with statistical significance （P 〈 0. 0001 ）. Conclusions High prevalence and low identification and treatment rate of depressive and/or anxiety disorders were found in the general hospitals. In order to improve the status quo, training program for physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.