艾滋病门诊患者发生抑郁的相关影响因素Logistic回归分析

Multi-variate Logistic regression analysis of influencing factors of the depression in the HIV-infected out-patients

目的了解艾滋病门诊患者抑郁的发生率和艾滋病病毒携带者/艾滋病(HIV/AIDS)患者发生抑郁的相关影响因素,为制定有效的干预和保护措施提供参考。方法利用Zung设计的《抑郁自评量表》(SDS)对传染病专科医院的艾滋病门诊400例HIV/AIDS患者抑郁发生现况进行调查,并对其相关影响因素进行分析。结果艾滋病门诊患者抑郁的发生率为46.25%。将14个因素进行多因素Logistic回归分析,最终进入模型的因素为年龄、文化程度、疾病状态、社会支持、吸毒史、羞耻感、负性生活事件、药物副反应等八个方面,其调整的OR值及OR95%CI分别为4.133(1.774～9.627)、2.515(1.185～5.337)、5.038(1.941～13.076)、0.510(0.265～0.976)、2.913(1.194～7.110)、2.099(1.080～4.080)、29.753(17.965～56.155)、2.816(1.349～6.054)。结论艾滋病门诊患者抑郁的发生率高于国内常模;抑郁发生的危险因素,按OR值大小依次为负性生活事件、AIDS、≥50岁、吸毒史、药物副反应、文化程度、羞耻感;预防抑郁发生的保护因素主要为社会支持。

Objective To investigate the prevalence rate of depression and understand the influencing factors of depression in the HIV-infected outpatients, determine the risk and protective factors of depression, and provide valuable information for effective intervention measures. Methods Four hundred AIDS out-patients in the infectious disease speeial hospital were surveyed by Zung designed ＂Depression Scale＂ （SDS） to determine the prevalence rate of depression and the epidemiological influencing factors. Outcome was analyzed by SPSS16. 0. Results The preva- lence rate of depression in out-patients was 46. 25%. However fourteen factors was used to multivariate Logistic regression analysis, only eight factors eventually enter the model. These were age, education level, morbid state, social support, drug history, shame, negative life events, and adverse drug reaction , and the adjusted O^R values and OR CI respectively is 4. 133 （ 1. 774 ～ 9. 627 ）, 2. 515 （ 1. 185 ～ 5. 337 ）, 5.038 （ 1. 941 ～13.076 ）, 0. 510 （ 0. 265 ～O. 976）, 2. 913 （ I. 194～ 7. 110）, 2. 099 （ 1. 080 ～ 4. 080）, 29. 753 （ 17. 965～ 56. 155 ）, 2. 816 （ 1. 349 ～6. 054）. Conclusion Prevalence of depression in out-patients is significantly higher than the national norm. The risk factors for depression according to the relevance （ O^R ） in the order is negative life event, AIDS, ≥ history of 50 years, drug abuse, drug side effects, education level, a sense of shame. The protective factors of depression is social support.