医院焦虑抑郁量表在耳鼻咽喉科患者中的应用分析

Application of the hospital anxiety and depression scale among the inpatients of otolaryngology

目的通过医院焦虑抑郁量表(the hospital anxiety and depression scale,HAD)评估耳鼻咽喉科住院患者的焦虑和抑郁情况。方法对成年住院患者行HAD量表评估,以评分超过7分为区分值,并将鼻骨骨折作为对照组进行比较,并做性别、受教育程度等相关因素分析。结果 (1)感音神经性聋、分泌性中耳炎、突发性聋、良性阵发性位置性眩晕、周围性面瘫、慢性鼻-鼻窦炎、声带息肉、喉麻痹、真菌性鼻-鼻窦炎、阻塞性睡眠呼吸暂停低通气综合征表现出焦虑抑郁症状,与对照组相比差异显著(P均<0.001);(2)感音神经性聋和喉麻痹患者焦虑分值与受教育程度呈正相关,相关系数r分别为0.427和0.507,抑郁分值与受教育程度呈正相关,相关系数r分别为0.603和0.570。结论在耳鼻咽喉科患者中感音神经性聋、突发性聋等患者表现出显著焦虑抑郁症状,在临床诊治过程中应注意综合治疗。

OBJECTIVE To evaluate the status of the anxiety and depression in the inpatients of the otolaryngology with hospital anxiety and depression scale（HADs）. METHODS A cross-sectional study was conducted from October 2014 to September 2016 at the Department of Otolaryngology, Affiliated Hospital of Yan＇anUniversity. We recruited 624 Chinese otolaryngology＇s inpatients to determine the prevalence of anxiety and depression using the HADs. HADs consists of 14 items,depression（seven items） and anxiety（seven times）, each with four choices numbered alphabetically. Each of the subscales＇ scores ranges from 0 to 21, corresponding to total scores of 0 to 42, with higher scores indicating greater distress. Psychological distress was assessed for adult inpatients among the department of otolaryngology by a standardized HADs. In addition, the nasal bone fracture patients were treated as control and compared it to other diseases. Demographic data and clinical information collected from the patients and their hospital records were reviewed. RESULTS 1. Patients with sensorineural hearing loss, secretory otitis media, sudden sensorineural hearing loss, benign paroxysmal positional vertigo, peripheral facial paralysis, chronic sinusitis, polyp of vocal cord, laryngeal paralysis, fungal sinusitis and OSAHS revealed depressive and anxiety symptoms in comparison with the control. 2. Psychological distress of patients with sensorineural hearing loss and laryngeal paralysis were significantly related to education, which the anxiety or depression scores tended to increase with the education（P0.05）. CONCLUSION Depression and anxiety disorders were common in the local population of otolaryngology＇s inpatients. Recognizing the predictors for psychiatric morbidity could assist clinicians to identify those patients with a predisposition to developing psychiatric complications, and refer them for appropriate treatment. We recommend screening for psychological distress in patients with some otolaryngological diseases using a simple HAD tool to identify those patients who might benefit from a more psychologically based approach to therapy.