综合医院和精神专科医院心理咨询门诊的焦虑主诉患者症状学调查

Symptomatologic investigation in patients with anxiety as chief complaint from psychological counselling outpatients of general hospital and psychiatric hospital

目的：比较综合医院和精神专科医院心理咨询门诊以焦虑为主诉的患者症状学特点及相关因素。方法：采用自编调查表对以焦虑为主诉就诊于综合医院及精神专科医院心理门诊的患者进行人口学及症状学调查和分析。结果：综合医院组（449例）与精神专科医院组（972例）间性别、年龄、文化程度、婚姻、工作、经济状况比较差异有统计学意义（χ2=5.743~54.181,P〈0.05或P〈0.001）。患者例数〉50%的症状两组相同,依次为睡眠症状、疲劳、担忧、情绪低落、紧张、犹豫不决、急躁和心慌;紧张、犹豫不决、急躁的频数综合医院组明显高于专科医院组（χ2=6.078,χ2=4.954,χ2=4.034;P均〈0.05）。多元回归分析显示,初中文化、已婚、经济状况差是情绪症状影响因素（t=-1.983,t=-2.335,t=3.805;P〈0.05或P〈0.001）;出生地、工作或学习、经济状况差是躯体症状影响因素（t=-3.205,t=2.469,t=4.051;P〈0.05或P〈0.001）。结论：综合医院和精神专科医院以焦虑为主诉的患者主要症状相同;综合医院患者情绪症状更突出;经济状况差是情绪及躯体症状的共同影响因素。

Objective： To compare the symptomatology characteristics and their relevant factors in pa- tients with anxiety as chief complaint from psychological counselling outpatients of general hospital and psychiat- ric hospital. Method ： Using the self-made questionnaire, the data of demographic and symptomatology in pa- tients with anxiety as chief complaint in psychological counselling outpatients of general hospital and psychiatric hospital were investigated and analyzed. Results：Significant differences were found in gender, age, education level, marriage state, employment state, and financial condition between patients from general hospitals group and psychiatric hospitals group （ X2 = 5. 743 - 54.181, P 〈 0.05 or P 〈 0.001 ）. In the two groups, 8 items of major symptoms which incidence over 50% were same, in turn was sleep symptoms, fatigue, worry, low spirits, ner- vousness, hesitation, impatient, palpitation. The frequency of nervousness, hesitation and impatient in general hospitals group were significantly higher than those in psychiatric hospitals group （ X2 = 6. 078, X2 = 4. 954, X2 = 4. 034 ; all P 〈 0.05 ）. Muhiple regression analysis shows that the junior middle school of education level, married and poor financial condition were influencing factors of emotion symptoms （ t = - 1. 983, t = - 2. 335, t = 3. 805 ; P 〈 0.05 or P 〈 0. 001 ） ; while birthplace, employment state and poor financial condition were influ- encing factors of physical symptoms（t = -3.205,t=2.469,t=4.051;P〈0. 05orP〈0. 001）. Conclusion：The major symptoms in patients with anxiety as chief complaint in psychological counselling outpatients of general hospital and psychiatric hospital are same. The mood symptoms in patients from general hospital are more prominent. Poor economic condition is the common influence factors of emotional and physical symptoms.