抑郁症患者家庭功能及其相关影响因素分析

Family Function on Patients with Depression and Its Influential Factors

目的了解抑郁症患者家庭功能情况并分析影响其家庭功能的相关因素,为患者预后所需家庭支持治疗提供依据。方法选择2012年2月-2013年6月在四川大学华西医院心理卫生中心就诊的抑郁症患者125例及陪同家属各1例作为调查对象,并招募125例健康志愿者及其家属各1例作为对照组进行问卷调查,分别采用幸福与生活质量满意度问卷(Q-LES-Q)、领悟社会支持量表(MSPSS)、家庭功能评定量表(FAD)对所有被试进行调查,另外对125例抑郁症患者进行诊断性访谈以了解其本次发病情况。最终收回有效问卷488份,每组各122对。结果抑郁组家庭Q-LES-Q总平均分低于对照组家庭(t=-6.243,P<0.01);抑郁组家庭FAD各维度总平均分均高于对照组家庭(t=3.644、3.872、2.694、3.369、5.369、4.941、5.241,P<0.01)。根据FAD健康划界分计算,抑郁组家庭在问题解决沟通、情感反应、情感牵连、行为控制以及总体功能等6个维度上的不健康比例高于对照组家庭(χ2=6.778、23.698、26.580、39.875、17.123、10.712,P<0.05)。抑郁症患者家庭的生活质量满意度得分与FAD中6个维度(除角色、情感卷入维度外)得分均呈负相关(r=-0.388、-0.188、-0.200、-0.276、-0.370,P<0.05)。抑郁症患者家庭的社会支持得分与FAD中6个维度(除情感卷入维度外)得分均呈正相关(r=0.363、0.345、0.244、0.418、0.328、0.457,P<0.05)。与抑郁症患者家庭功能相关的影响因素包括患者性别、受教育时间、是否首发、是否有自杀企图、是否自杀未遂、抑郁发作次数等。结论抑郁症患者家庭生活满意度显著低于正常对照组,而其家庭功能在多方面存在一定缺陷。对其家庭功能产生影响的相关因素包括患者性别、受教育时间、是否首发、是否有自杀企图、是否自杀未遂、抑郁发作次数等,在对其日后的综合治疗中应充分考虑上述相关因素以达到良好的预后效果。

Objective To explore the family function on patients with depression and its influential factors, in order to provide a basis for family support treatment for the patients. Methods A total of 122 depressed patients from Mental Health Center of West China Hospital between February 2012 and June 2013, and one of their family members were chosen to be the study subjects. Another 122 non-clinical controls and one of their family members were recruited from a community near Sichuan University were regarded as the controls. All the subjects were asked to finish the Quality of Life Enjoyment and Satisfaction Questionnaire （Q-LES-Q）, the Multidimensional Scale of Perceived Social Support （MSPSS）, and the Family Assessment Device （FAD）. Additionally, the patients received a diagnostic interview to provide the features of their depression. Results The general average score of Q-LES-Q in families with depressed patients was significantly lower than that in the control families （t=-6.243, P 〈 0.01）. The general average score of each dimension in FAD for families with depressed patients was significantly higher than that for control families （t=3,644, 3.872, 2.694, 3.369, 5.369, 4.941, 5.241; P 〈 0.01）. According to FAD health division scoring, the unhealthy proportion in terms of communication, emotional reaction, emotional link, behavioral control and general function for families with depressed patients was significantly higher than that for control families （X2=6.778, 23.698, 26.580, 39.875, 17.123, 10.712; P 〈 0.05）. The Q-LES-Q scores and the five FAD dimensional scores （except role and affective involvement） were negatively correlated （r=-0.388, -0.188, -0.200, -0.276, -0.370; P ~ 0.05）. The scores of perceived social support for families with depressed patients had significant positive correlations with the scores of all FAD dimensions except affective involvement （r=0.363, 0.345, 0.244, 0.418, 0.328, 0.457; P 〈 0.05）. The risk factors for unhealthy family function included： female （OR=1.141, P 〈 0.05）, poor education （OR=0.948, P 〈 0.01）, first-episode （OR=1.416, P 〈 0.05）, suicidal attempt （OR--1.014, P 〈 0.05）, incomplete suicide （0R=1.367, P 〈 0.01） and depression episode number （OR=1.035, P 〈 0.05）. Conclusions Depression is associated with impaired family function in Chinese families. Female, poor education, first episode of depression, suicidal attempt, incomplete suicide and depression episode number are the influential factors for family function on patients with depression.