综合医院门诊首发抑郁患者服药早期依从性影响因素分析

Influencing factors of medication compliance of outpatients with first episode depression in a general hospital

目的探讨影响首发抑郁患者服药早期依从性的影响因素。方法选取2011年3月到2013年3月之间就诊于本科心理门诊的150例首次发作的抑郁症患者,采用问卷调查方法,问卷内容包括患者一般资料、患者对疾病的认识及治疗的态度、治疗依从性评价、领悟社会支持量表(PSSS)、卡特尔16种人格因素量表(16PF)。采用χ2检验、t检验及多元Logistic回归分析,探讨上述各因素与服药第1个月依从性的相关性。结果在治疗后第1个月,依从性好组与依从性差组在家庭月收入、诊断认可度、病耻感、对疾病的了解程度、担心药物的副作用程度、PSSS评分及16PF人格测试中稳定性、有恒性、敏感性、忧虑性评分方面差异有统计学意义(P<0.05,P<0.01);将患者服药依从情况作为因变量,将以上项目作为自变量进行Logistic回归,结果显示社会支持、家庭月收入、病耻感、担心药物的副作用程度、对疾病的了解程度、对诊断的认可度、稳定性、敏感性、忧虑性进入回归方程,各变量比值比分别为9.523、6.088、5.368、4.237、3.213、2.519、2.246、0.532、0.207。结论影响抑郁症患者服药依从性的重要因素很多,家庭月收入、诊断认可度、病耻感、对疾病的了解程度、担心药物的副作用程度、社会支持及人格可以预测患者的依从性。

Objective To determine the influencing factors of medication compliance of outpatients with first episode depression. Methods One hundred and fifty outpatients with first episode depression in our department from March 2011 to March 2013 were recruited in this study. The investigation was carried out with questionnaires, including general conditions, understanding and attitude of disease, treatment compliance evaluation, perceived social support scale, and Cattell-16 personality factor questionnaire. The obtained data were analyzed by Chi- square test, student’s t test and multivariate logistic regression analysis for the relationship of above indexes with medication compliance within the first month. Results Good compliance group had statistical differences in the family monthly income, recognition of diagnosis, stigma, understanding of the disease, worry about side effects of drugs, social support score and 16PF personality including stability, sensitivity, perseverance and anxiety when compared with poor compliance group （P〈0.05）. Logistic regression analysis showed that odds ratio （OR） value of social support, the family monthly income, stigma, worry about side effects of drugs, understanding disease knowledge, recognition of diagnosis, perseverance, sensitivity, and anxiety were 9.523, 6.088, 5.368, 4.237, 3.213, 2.519, 2.246, 0.532, and 0.207 respectively. Conclusion Many important influencing factors affect drug compliance in depressive patients. Family monthly income, diagnosis recognition, stigma, understanding of disease, social support, worry about side effects of drugs and personality can predict patient compliance in those with first episode depression.