综合医院五个非精神科门诊焦虑障碍现状分析

Analysis on the Prevalence of Anxiety Disorders among the Outpatients of Five Non-Pychiatric Departments from General Hospital

目的了解三级甲等综合医院非精神科门诊就诊者中焦虑障碍的患病率现状,以及医生对焦虑障碍的诊疗情况。方法对广州市第一人民医院的神经科、消化科、心血管科、内分泌科和妇科五个科室门诊就诊的645名患者进行焦虑障碍患病率调查。采用医院焦虑抑郁量表(HADS)进行筛查,由精神科医师对HADS≥8分的筛查阳性者进行国际神经精神科简式访谈问卷((MINI)的评估。并获取门诊医师关于焦虑障碍治疗信息。结果MINI诊断现患焦虑障碍者34例,失访校正后的焦虑障碍现患病率为7.44%,焦虑谱系障碍中最常见的是广泛性焦虑障碍(3.88%)。仅有5.9%的焦虑障碍患者给予了精神类药治疗,无1例给予建议专科转诊治疗。结论焦虑障碍是综合医院非精神科门诊就诊者中的常见问题,但识别率和治疗率均不高。

Objective To investigate the prevalence rates of anxiety disorders of the non- pychiatric outpatients in Third- Level Grade- A general hospitals,and assess the doctors’ opinions about diagnosis and treatment of anxiety disorders. Methods A survey was conducted in the neurology,cardiology,gastroenterology,endocrinology and gynecology outpatient departments of Guangzhou First People’s Hospital. A total of 645 outpatients were screened with hospital anxiety and depression scale（ HADS）. The patients with the HADS score of 8 and over were investigated and diagnosed by psychiatrists with the mini- international neuropsychiatric interview（ MINI）. The information of the clinic doctors’ treatment was collected. Results There were 34 outpatients with MINI- diagnosed anxiety disorder,and the adjusted prevalence rate of anxiety disorder were 7. 44%. The general anxiety disorder（ GAD） was most common（ 3. 88%） anxiety disorder spectrum. Among the outpatients with anxiety disorder only 5. 9% were recommended taking antipsychotic drugs,and no- one consulting psychiatric department. Conclusion Anxiety disorders are common problems in the non- pychiatric outpatient departments of general hospitals,but few outpatients were well- diagnosed and treated.