1992年与2002年综合医院门诊抑郁症患者治疗情况与5年复诊率比较

Comparisons of the Follow-up Rates and the Treatment of the Patients with Depression Disorder Visiting in the Psychological Clinic of the General Hospital During the Year of 1992 and 2002

目的:比较1992年与2002年全年某综合性医院医学心理专科门诊抑郁症患者的药物治疗及随访率变化。方法:分别选取1992年1月1日—12月31日在上海市第一人民医院医学心理门诊就诊的抑郁症初诊病例以及2002年1月1日—2002年12月31日就诊的抑郁症初诊病例,记录其药物应用情况及初诊后1个月、6个月、1年、3年和5年的复诊和失随访情况。结果:初诊抑郁症患者1992年35例,2002年305例,10年间增长了约9倍。常用抗抑郁药物1992年为三环类(71.34%),2002年则为选择性5-羟色胺再摄取抑制剂(95.41%)(P<0.05)。门诊抑郁症患者坚持门诊复诊、随时间推移下降,1992年与2002年的1个月、6个月、1年、3年、5年门诊复诊率分别为42.86%和53.77%、22.86%和34.43%、22.86%和26.89%、11.43%和12.79%、5.71%和10.49%。结论:10年间门诊抑郁症患者的就诊例数明显增加,抗抑郁药物的应用种类发生了显著变化,但维持治疗、坚持门诊随访者的比例仍较低。

Objective：To compare the follow up rate and drug treatment of patients with depression disorder visiting the psychological clinic of the general hospital during the year of 1992 and 2002.Methods： We selected all 35 cases of the patients with depression disorder first visiting the psychological clinic during Jan 1st to Dec 31st in 1992,and all 305 cases of the patients with depression disorder first visiting the psychological clinic during Jan 1st to Dec 31st in 2002.The follow up situation at different spot time（one month,six month,one year,three year,five year） the detailed information of every patient＇s drug application and the improvement of his psychological situation were recorded.Results： There were 35 cases of patients with depression disorder first visiting in the psychological clinic in 1992,but 305 cases in 2002.The number had increased about nine times during these ten years.In 1992,the doctors got used to prescribe traditional tricyclic antidepressant（71.24%）.However,in 2002,the doctors selected new type selective serotonin reuptake inhibitor（95.41%,P0.05） instead of traditional drugs gradually.The follow up rate at different spot time decreased gradually.There was no significant difference between follow up rate at the year of 1992 and 2002.Conclusions： The number of patients with depression disorder visiting in the psychological clinic has increased rapidly during past ten years.There has a great change in the field of drug treatment.Nevertheless,it is well known that the patients′ compliance to the doctor′s prescription is always poor.The proportion of the patients keeping follow up in the clinic is still very low.