抑郁障碍患者抗抑郁药物使用情况及影响因素分析

Analysis of the use of antidepressants and its influencing factors among depressive patients

目的分析海口市抑郁障碍患者抗抑郁药物使用情况及其影响因素，为临床合理用药提供一定参考。方法选取海口市310例抑郁障碍患者。使用自拟一般情况及药物使用问卷、一般自我效能感量表（general self-efficacy scale，GSES），精神病人生存质量问卷（quality of life questionnaire for psychiatric patients，QOL-P），汉密尔顿抑郁量表（HAMD-17）对所有患者进行测评。结果（1）五羟色胺再摄取抑制剂（SSRIs）药物使用率为53．22％，三环类抗抑郁药（TCAs）使用率为30．32％，其他新型抗抑郁药物使用率为16．45％。（2）患者的自我效能感（β=-0．473，OR=0．713，P=0．030）、社会功能（β=0．371，OR=1．437，P=0．036）、家庭经济收入（β=-1．242，OR=0．423，P=0．001）是影响患者选择TCAs药物的因素；家庭经济收入（β=-1．762，OR=0．234，P=0．001）、付费方式（β=0．248，OR=1．157，P=0．030）是影响患者选择SSRIs药物的因素；自我效能感（β=0．563，OR=1．913，P=0．041）和抑郁状态（β=0．543，OR=2．225，P=0．026）是影响患者选择其他新型抗抑郁药物的因素。结论五羟色胺再摄取抑制剂和三环类抗抑郁药等传统抗抑郁药物仍被抑郁障碍患者广泛选择使用。自我效能感、社会功能、经济收入、付费方式等可对抑郁障碍患者的药物选择产生影响。

Objective To analyze the use of antidepressants and its influencing factors in patients with depressive disorders in Haikou City, and to provide some reference for clinical rational drug use. Methods 310 patients with depressive disorder in Haikou were selected. All patients were assessed with the self- designed General Situation and Drug Use Questionnaire, General Self-efficacy Scale （GSES） , Quality of Life Questionnaire for Psychiatric Patients （QOL-P） and Hamilton Depression Scale （HAMD-17）. Results （ 1 ）The usage rate of serotonin reuptake inhibitors （SSRIs） was 53.22%, 30.32% for tricyclie antidepressants （TCAs） and 16.45% for other new antidepressants. （2） Patients＇self-efficacy （β= - 0. 473, OR= 0.713, P= 0. 030）, social function （β= 0.371, OR = 1. 437, P = 0. 036 ）, family income （β = - 1. 242, OR = 0. 423 ,P= 0. 001 ） were the factors influencing patients＇ choice of TCAs ; family income （β= - 1. 762, OR= 0. 234,P= 0. 001 ）, payment method （β= 0. 248, OR= 1. 157, P= 0. 030） were the factors influencing the choice of SSRIs drugs ; self-efficacy （β= 0. 563, OR= 1. 913, P= 0. 041 ） and depression （β= 0. 543, OR= 2. 225, P= 0. 026） were the factors influencing the choice of other new antidepressants. Conclusion Traditional antidepressants such as serotonin reuptake inhibitors and tricyclic antidepressants are still widely used in patients with depressive disorders. Self-efficacy, social function, income, and payment methods can influence the drug selection of depressive patients.