焦虑障碍危险因素病例对照研究

A case-control study of risk factors of anxiety disorder

目的：探讨焦虑障碍及其中强迫症、恐怖症发生的危险因素.方法：以北京市精神障碍流行病学调查使用复合性国际诊断交谈表（CIDI-3.0）所获得的社区焦虑障碍患者150例、恐怖症患者103例、强迫症患者60人作为三个独立的病例组;选择调查所获正常人群737人作为共用的对照组,进行病例对照研究.采用多因素非条件logistic回归分析焦虑障碍的危险因素.结果：焦虑障碍的危险因素为父母物质剥夺（OR=3.95,95％ CI：1.20～12.95）和父母让其做过危险事情（OR=z06,95％ CI：1.22～3.51）.强迫症的危险因素为女性（OR =2.31,95％CI：1.15 ～4.62）、农村居住地（OR=4.49,95％CI：1.48～13.64）、家庭收入不能满足日常需要（OR=2.15,95％CI：1.14～4.07）.恐怖症的危险因素为父母物质剥夺（OR=5.04,95％ CI：1.43 ～ 17.82）.结论：影响焦虑障碍及其中强迫症和恐怖症发生的危险因素主要为童年期的不良经历,包括不良的家庭生活环境和父母养育方式.

Objectives： To explore risk factors of anxiety disorder and its two subtypes, phobia disorder and obsessive-compulsive disorder （OCD）. Methods： The subjects were selected from the epidemiological cross-sectional study in Xicheng, Fengtai, Haidian, Shunyi, Daxing and Yanqing Districts, Beijing. With the Composite International Diagnostic Interview the third version （CIDI-3.0）, 150 patients with anxiety disorder, 103 patients with phobia disorder and 60 patients with obsessive and compulsive disorder were selected as three case groups, and 737 normal people were selected as the control group. All data were analyzed by using SPSS13.0 software for statistical description and analysis. Risk factors were analyzed with multivariate analysis. Non-conditional backward stepwise logistic regression analysis was used. Anxiety disorder was the dependent variable, and the variables with significant difference by Pearson X2 analysis were the independent variables. Results： It showed that the risk factors of anxiety disorders included material deprivation by parents （OR = 3.95, 95% CI： 1.20 - 12. 95） and being forced to do dan- gerous things （ OR =2. 06, 95% CI： 1.22 - 3.51）. The risk factors of OCD included female （ OR = 2. 31, 95% CI： 1.15 -4. 62）, rural residency （ OR = 4.49, 95 % CI： 1.48 - 13.64）, and being unmet of earning for daily needs （ OR = 2. 15, 95% CI： 1.14 -4. 07）. The risk factor of phobia disorder was material deprivation by parents （OR = 5.04, 95% CI： 1.43 - 17.82）. Conclusion： It is indicated that risk factors of anxiety disorders and its two subtypes, phobia disorder and obsessive-compulsive disorder may be adverse family environment and poor parental rearing behavior. It should be advocated to improve family environment and social support network.