上海市某社区卫生服务中心60岁以上就诊人群抑郁状况调查

AsurveyondepressionstatusinelderlypatientsfromonecommunityhealthservicecenterinShanghai

目的了解上海初级卫生保健系统老年就诊人群的抑郁状况,分析可能的相关危险因素.方法2011年4月至6月间,对在石门二路社区卫生服务中心就诊的1332例≥60岁患者,以一对一的方式,进行患者健康问卷抑郁量表（PHQ-9）、一般情况调查表及社会支持评定量表问卷调查.其中男性554例（41.6％）,女性778例（58.4％）;平均年龄（72±11）岁.结果258例（19.6％,258/1318）检出有抑郁症状,其中13.4％（176/1318）为有轻度抑郁.平均社会支持总分为（33.2±8.9）分;有抑郁症状者的主观支持分（19.4±4.6）分、客观支持分（6.3±2.9）分、对支持的利用度（5.9±2.5）分,均低于无抑郁者的（21.6±4.7）、（7.1±3.0）和（6.3±2.5）分,差异有统计学意义（t值分别为6.37、3.83和2.72,均P＜0.01）.配偶关系、生活满意度、每月医疗费用占家庭开支的百分比、户外运动及客观社会支持等5个变量进入logistic回归方程.结论与配偶不和谐、生活满意度低、医疗负担重、户外运动及客观社会支持少,是老年人抑郁的相关因素.应警惕这部分患者潜在的抑郁倾向.

ObjectiveTosurveytheprevalenceofdepressivesymptomsandrelatedriskfactorsamongelderlypatientsinprimarycaresettingsinShanghai.MethodsTotal1332patientsaged60orabove,whowerevisitedShanghaiShimenErluCommunityHealthServicecenterfromApriltoJuneof2011,wereincludedinthesurvey,including554malesand778femaleswithanaverageageof72±11.Ascreeningquestionnairebasedonthepatienthealthquestionnaire-9（PHQ-9）wasappliedinthesurvey,thesociodemographicandhealth-relatedvariableswereanalyzed,andsocialsupportscalewasevaluated.ResultsTotal258（19.6%）patientshaddepressivesymptomsinthisstudyand13.4%（176/1318）ofthemhadminordepression.Theaveragesocialsupportscorewas（33.2±8.9）.Thereweresignificantdifferencesinsubjectivesupport,objectivesupportandusageofsupportbetweenthedepressiveandnon-depressivepatients（t=6.37,3.83,2.72respectively,P〈0.01）.Therewere5variablesintologisticregressionequationincludingrelationshipwithspouses,lifesatisfaction,percentageofmedicalcostsovertotalhouseholdexpenses,outdoorexerciseandobjectivesocialsupport.ConclusionsMaritaldisharmony,poorlifesatisfaction,theburdenofmedicalcosts,lessexercisesandlessobjectivesupportarethemainriskfactorsassociatedwithdepressionstatusofelderlypatientsinthecommunity.