北京部分综合医院门诊就诊者焦虑障碍的现况调查

Prevalence of Anxiety Disorders in Outpatient Departments of General Hospitals in Beijing

目的了解北京部分综合医院门诊就诊者焦虑障碍的现况。方法以医院为基础进行横断面调查,选取三所三级甲等综合医院的心血管科、消化科、神经科和妇科门诊为研究点,以指定调查日内年龄≥18岁、意识清楚、能独立回答问题并知情同意的就诊者为调查对象,顺序纳入。患者完成一般问卷、医院焦虑抑郁量表(HADS)的自评筛查;就诊科室医生在不了解筛查结果的情况下独立完成诊疗;精神科医师对HADS≥8分的筛查阳性者进行国际神经精神科简式访谈问卷(M.I.N.I.)的诊断性评估。对于已知情同意并完成筛查,但是拒绝精神科医生诊断性检查的就诊者按失访处理。结果实际完成调查的就诊者共2 074例。经失访校正后的焦虑障碍现患率为7.6%(157/2 074),男性为6.5%(43/661),女性为8.1%(114/1 399),性别间差异无统计学意义(P>0.05);其中广泛性焦虑障碍为2.8%(59/2 074),场所恐惧症为1.7%(35/2 074),特定恐怖症为1.4%(29/2 074),惊恐障碍为1.1%(23/2 074),社交恐惧症为1.1%(23/2 074),强迫障碍0.6%(12/2 074),混合性焦虑抑郁障碍为0.6%(12/2 074;87.3%(137/157)的就诊者只患有一种焦虑障碍。经失访校正后的终身患病率为8.7%(180/2 074),男性为7.6%(50/661),女性为9.3%(130/1 399),性别差异无统计学意义(P>0.05);其中,广泛性焦虑障碍为2.8%(59/2 074),场所恐惧症为2.2%(45/2 074),惊恐障碍为2.1%(43/2 074),特定恐怖症为1.4%(29/2 074),社交恐惧症为1.1%(23/2 074),强迫障碍0.6%(12/2 074),混合性焦虑抑郁障碍0.6%(12/2 074);84.4%(152/180)的焦虑障碍患者只患有一种焦虑障碍。结论焦虑障碍是三级综合医院就诊者中的常见问题,男女患病率间无明显差异,且以广泛性焦虑障碍诊断居多,大多数患者只患有一种焦虑障碍。

Objective To explore the prevalence of anxiety disorders in outpatient departments of a part of general hos- pitals in Beijing. Methods A hospital - based cross - sectional study was conducted. The subjects were recruited from the three Third- Level Grade -A hospitals, who visited the cardiology, gastroenterology, neurology and gynecology outpatient depart- ments, and who aged 18 or over, were conscious and with informed consent, and can finish the questionnaire independent- ly. They finished the general questionnaire and Hospital Anxiety and Depression Scale （HADS） . The subjects with HADS score of 8 or over were surveyed and diagnosed with Mini International Neuropsychiatric Interview （MINI） by psychiatrists. All the sub- jects, who refused to receive diagnostic examination by psychiatrists, were treated as the case of loss of follow - up. Results A total 2 074 subjects were included in the survey. The adjusted prevalence rate of MINI - diagnosed anxiety disorder was 7.6% （ 157/2 074）, and there was no significant difference between male and female [ 6.5% （43/661） vs 8.1% （ 114/1 399） ~ （ P 〉0. 05 ） . Among them the prevalence of general anxiety disorder, agoraphobia, specific phobia, panic phobia, social phobia and compulsive -obsessive disorder was 2. 8% （59/2 074）, 1.7% （35/2 074）, 1.4% （29/2 074）, 1.1% （23/2 074）,1.1% （23/2 074）, 0.6% （ 12/2 074）, 0. 6% （ 12/2 074）, respectively. And 87. 3% （ 137/157 ） suffered from only one kind of anxiety disorders. The adjusted prevalence rate of lifetime anxiety disorder was 8. 7% （ 180/2 074）, and there was no gen- der difference [ 7.6% （50/661） for male and 9. 3% （130/1 399） for female~ （P 〉 O. 05 ） . The adjusted prevalence of lifetime general anxiety disorder, agoraphobia, specific phobia, panic phobia, social phobia and compulsive -obsessive disorder was 2.8% （59/2 074）, 2. 2% （45/2 074）, 2. 1% （43/2 074）, 1.4% （29/2 074）, 1.1% （23/2 074）, 0.6% （12/2074）, 0. 6% （ 12/2 074）, respectively. And 84. 4% （152/180） suffered from only one kind of anxiety disorders. Conclusion Anxiety disorder is one kind of common problems in Third - Level hospitals of Beijing and there is no significant difference between male and female. The general anxiety disorder is the most common and most patients only suffered from one kind of anxiety disorders.