男科门诊常见疾病患者抑郁焦虑患病特点的单中心大样本调查研究

Large-scale single-center investigation of the prevalence and patterns of depression and anxiety in outpatients of andrology clinic

目的：评估男科门诊常见疾病患者中抑郁焦虑的发病率及特征。方法：纳入2014年3月-2015年3月就诊于我院男科中心门诊的常见男科疾病患者1 489例,了解原发疾病、年龄、身高、体重、学历、职业等信息,采用患者抑郁自评工具[9条目患者健康问卷（PHQ-9）]和广泛性焦虑障碍量表（GAD-7）进行抑郁和焦虑的评价。结果：1 489例患者中,＂感觉疲惫或没有活力＂和＂变得容易烦恼或急躁＂分别成为抑郁和焦虑最普遍的症状。57%患者诊断为抑郁,其中轻度抑郁患者占31%,重度抑郁患者仅占3%;而42%患者诊断为焦虑,其中轻度焦虑患者占27%,重度焦虑患者仅占1%。学历相对较高及从事脑力劳动的患者相对不容易受抑郁困扰。迟发性性腺功能减退症、勃起功能障碍和慢性前列腺炎三种疾病诊断抑郁、焦虑的比例最高,不育症、BPH相对诊断比例和严重患者比例较低。共病患者总人数535例,占总人数的35.9%,占罹患抑郁或焦虑患者的56.4%。结论：男科常见疾病抑郁焦虑发病率高,迟发性性腺功能减退症、勃起功能障碍和慢性前列腺炎患者以及学历相对较低、从事体力劳动的患者风险更高。疾病程度以轻度、中度为主,应客观针对原发疾病和合并精神因素进行评估。

Objective：To illustrate the prevalence and patterns of depression and anxiety in outpatients of andrology clinic.Method：From March 2014 to March 2015,1489 patients treated at andrology clinic of our hospital were investigated.The presence and severity of depression and anxiety were evaluated by PHQ-9and GAD-7.The data of primary disease,age,height,weight,educational background and occupation were also reviewed.Result：For all 1 489 patients the most common symptom for depression was ＂feeling tired＂,while for anxiety was ＂easily irritated＂.Depression was diagnosed in 57% patients,and the ratio of mild depression was 31%,while severe depression was only 3%.Anxiety was diagnosed in 42% patients including mild anxiety 27% and severe anxiety1%.Patients who received higher education and who participated in mental labor were less likely to suffer from depression.Patients with late-onset hypogonadism（LOH）,erectile dysfunction（ED）and chronic prostatitis（CP）exhibited higher risk of depression and anxiety,while less prevalence was found in patients with BPH and infertility.Both two diseases were diagnosed in 535patients（35.9%）with a percentage of 56.4%in the cohort of patients who had at least one of the disease.Conclusion：The prevalence of depression and anxiety in outpatients of andrology clinic was high.Patients with LOH,ED,CP and those who have poor educational background or participate in physical work have higher risk of depression and anxiety.Most patients were diagnosed with mild to moderate stage,and it＇s important to evaluate the primary disease and the combined psychogenic problems objectively.