浏阳市农村社区抑郁症患者就诊率及其影响因素分析

Visiting Rate of Patients with Depression and It's Influential Factors in Rural Communities of Liuyang

目的:探讨农村抑郁症患者的就医情况及其影响因素。方法:以浏阳市≥15岁农村居民抑郁症抽样调查中发现并确诊的抑郁症患者295例为研究对象,全部符合DSM-IV标准。由调查员对所有调查对象询问并填写"精神障碍患者求医行为调查表"(自编)。结果:有13.5%(45/295)的患者曾到乡(镇)卫生院及以上医疗机构就诊,女性就诊率(18.9%)显著高于男性(9.1%)。多元Logistic回归分析结果,影响抑郁症患者就诊率因素有性别(OR=0.363)、年龄(OR=1.040)、家庭主事人职业(OR=0.352)、家庭类型(OR=2.593)和精神病家族史(OR=3.642)。45例曾经就诊的患者中,有5例(1.7%)重症抑郁发作患者曾就诊于精神专科,仅有3例(1.0%)既往重症抑郁发作患者接受过精神科药物治疗。结论:浏阳市农村抑郁症患者卫生服务利用率很低,影响卫生服务利用的因素主要是性别、年龄、受教育程度、家庭类型、家庭人均收入、家庭主事人职业等。

Objective：To research the rate of visiting medical institutions of patients with depression.Methods：The objects of this study were 295 patients with depression,234 cases with MDE and 61 cases with dysthymic disorder,who were screened out and confirmed in the sampling survey of depression in rural residents of Liuyang from March to May 2007,all accorded with the DSM-IV criteria.All of the objects were interviewed with ＂Quetionaire on Behaviors of Help Seeking of Patients with Mental Disorders＂（self-compiled） by investigators.Results：45 cases（13.5%） had sought help from xiang/town health centre or other formal medical institutions of higher level.The rate of seeking help from formal medical institutions in females（18.9%） was higher than in males（9.1%）,and the difference had statistical significance（χ^2=5.541,P=0.023）.The results of multiple logistic regression analysis showed that the influential factors on the rate of help-seeking were sex（OR=0.363,95%CI：0.164～0.805）,age（OR=1.040,1.012～1.069）,occupation of the decision maker of the family（OR=0.352,0.176～0.707）,the type of family（OR=2.593,1.292～5.204）,family history of mental disorder（OR= 3.642,1.084～12.235）.Among 45 patients who had sought help from medical institutions,1.7%（5/295） of the patients with MDE had ever gone to psychiatrists,and only 3 cases（1.0%） with past MDE had been treated by psychiatric drugs.Conclusion：The utilazation of mental health services is considerablly poor in rural patients with depression in Liuyang.The factors effect on the utilization of health services are sex,age,education level,family type,income per capita of the family and occupation of the decision maker in family.