抑郁症患者延误治疗的影响因素分析

Influential factors of delayed treatment in patients with depression

目的:探讨抑郁症患者延误治疗的影响因素。方法:以是否有延误治疗的情况将67例住院的抑郁症患者分为延误治疗组(47例)和非延误治疗组(20例);采用自制调查表收集入组者一般及临床资料,并进行分析比较。结果:本组70%患者延误治疗。延误治疗组中,≤高中文化、居住在农村、间断性病程、急性起病、抑郁症家族史、首诊主诉为躯体症状、在综合医院就诊、有自知力、接受抑郁症诊断及有药物治疗意愿的比率与非延误治疗组比较差异有统计学意义(P均<0.05);Logistic回归分析显示文化程度、病程、起病形式、家族史、求医方式、自身对疾病的认识、诊断的接受性、是否愿意接受药物治疗进入回归方程,标准回归系数分别为0.34,0.23,0.35,0.26,0.11,0.20,0.36,0.38。结论:抑郁症患者延误治疗的发生率高;高中以下文化程度、连续性病程、急性起病、阴性家族史、在综合医院治疗、无自知力、不愿接受诊断标签和药物治疗可能是延误治疗的因素。

Objective： To analyze the influential factors of delayed treatment in patients with depression. Method：According to whether there was a delay in treatment, 67 hospitalized patients with depression were divided into delayed treatment group （47 cases） and non-delayed treatment group （20 cases）. The general and clinical data of the patients in the two groups were collected by self-designed questionnaires, and carried on the analysis comparison. Results：The rate of patients with delayed treatment was 70%. In the delayed treatment group the rates of education below high school, living in countryside, discontinuity course of the disease, acute onset, family history of depression, somatic symptoms as the chief complaint at initial diagnosis, treated in comprehensive hospital, without insight, acceptation for the diagnosis and willingness of drug treatment had statistical significance compared to non-delayed treatment group （ all P 〈 0.05 ）. Logistic regression analysis showed that the cultural degree, duration, onset form, family history, seeking treatment methods, understanding of disease, accepted diagnosis, willing to accept medication entered the regression equation. The standard regression coefficient were 0.34,0.23,0.35,0.26,0.11,0.20,0.36,0.38, respectively. Conclusion：The rate of delayed treatment in patients with depression is higher. The influential factors may be the education level below high school, continuity of course, acute onset, negative family history, treatment in comprehensive hospital, without insight, unwilling to accept diagnostic labels and drug therapy.