抑郁症共病焦虑障碍临床特征及相关因素分析

Clinic characteristics and related factors of depression comorbid with anxiety disorders

目的了解社区人群中抑郁症共病焦虑障碍发生率、临床特征及相关因素。方法在2010年福建厦门市精神疾病流行病学调查中抽取145例年龄≥18岁抑郁症患者为研究对象，全部患者用《美国精神障碍诊断与统计手册（第四版）轴I障碍定式临床检查（患者版）》SCID-I／P进行诊断，研究工具为一般人口学资料调查问卷、十二项一般健康问卷（GHQ-12）、简易生命质量量表和功能大体评定量表（GAF）。结果社区人群中抑郁症共病焦虑障碍的患病率为0．37％（95％CI=0．27％～0．51％），共病焦虑障碍主要以创伤后应激障碍和未特定焦虑障碍为主，共病组患者中精神运动激越、优柔寡断症状比例明显高于非共病组（60％VS．34．41％，56％VS．29．03％，均P〈0．05），共病组患者中生命质量得分明显低于非共病组[（43．32±11．32）VS．（50．37±13．90），P〈0．05]，多因素logistic归分析显示居住农村是共病焦虑障碍的保护因素，有精神疾病家族史为危险因素。结论抑郁症共病焦虑障碍的患病率相对较低，但特别要重点关注居住在城镇、有精神疾病家族史的抑郁症患者。

Objective To explore the prevalence, clinical characteristics and related factors of depression comorbid with anxiety disorders. Methods A total of 145 depresion patients aged ≥ 18 years were selected from the dataset of an epidemiological survey for mental disorders in Xiamen city and diagnosed with Structured Clinical Interview for Diagnos- tic and Statistical Manual of Mental Disorders-IV-TR Axis I Disorders-Patient Edition （SCID-//P）. The quality of life and function status of the patients were assessed with quality of life questionnaire and Global Assessment of Functioning （GAF）. Results The prevalence of depression comordid with anxiety disorders was 0.73% （95 % confidence interval [95% CI] ：0. 27% -0. 51% ）, and post-traumatic stress disorder and unspecified anxiety disorders were common in the depression patients comordid with anxiety disorders. The psychomotor agitation and indecision of the comorbidity group were significantly higher than those without the comorbidity（60.00% vs 34.41% ,56.00% vs 29.03% ）. The total score of the life quality in comorbidity group was significantly lower than that without the comorbidity （43.32 ± 11.32 vs 50. 37 ± 13.90）. Multivariate logistic regression analyses showed that living in rural area could reduce the occurrence of anxiety disorders and family history of psychiatric disorders was a risk factor of the comorbidity. Conclusion The preva- lence of depression comorbid with anxiety disorders was relatively low in Xiamen city ,but more attentions should be paid on depression patients in urban areas or with family history of psychiatric disorders.