老年慢性病患者焦虑与抑郁影响因素分析

Study on the influencing factors of depression and anxiety in elderly patients with chronic diseases

目的在国家政策倡导积极老龄化的背景下,老年慢性病患者的心理健康问题备受医学、人口学等学科关注,心理与生理的互相影响也是当前促进慢性病治疗的积极方式。本研究旨在分析老年慢性病患者焦虑与抑郁影响因素,探讨各因素与焦虑、抑郁之间的关系,从而对老年慢性病患者焦虑和抑郁的缓解提供帮助。方法利用2011年"北京市城镇老年人焦虑与抑郁症状调查"数据,将≥60岁老年人通过"看病"和"体检"的方式确诊患有慢性病筛选得到877个样本量,使用SPSS 19.0做二元Logistics回归分析相关变量对老年慢性病患者焦虑、抑郁的影响。结果抑郁患者对照组男272例,女439例,平均年龄(71.00±6.90)岁,病例组男57例,女109例,平均年龄(70.00±7.07)岁,两组性别(χ~2=0.882,P=0.348)和年龄(t=1.167,P>0.05)差异无统计学意义;焦虑患者对照组男294例,女434例,平均年龄(71.00±6.95)岁,病例组男26例,女92例,平均年龄(69.00±6.24)岁,两组性别(χ~2=14.540,P<0.001)和年龄(t=2.931,P=0.01)差异有统计学意义。年龄小(95%CI为0.635~0.890,P=0.001)、患病数多(95%CI为1.151~1.364,P<0.001)和亲属支持少(95%CI为0.938~0.984,P=0.001)是老年慢性患者抑郁的危险因素;年龄小(95%CI为0.641~0.961,P=0.019)、文化程度低(不识字:95%CI为1.537~11.911,P=0.005;初中:95%CI为1.277~7.080,P=0.012)、患病数多(95%CI为1.120~1.362,P<0.001)和亲属支持少(95%CI为0.944~0.995,P=0.022)是老年慢性病患者发生焦虑的危险因素。结论年龄越低、教育程度越低、患病数越多和交往密切亲属越少,老年慢性病患者心理焦虑和抑郁情况越差。

OBJECTIVE Under the background of active aging advocated by the national policy,the mental health problems of the elderly patients with chronic diseases have attracted much attention in medicine,demography and other disciplines.The mutual influence of psychology and physiology is also the positive means to promote the treatment of chronic diseases.Therefore,the purpose of this study is to analyze the factors affecting anxiety and depression in elderly patients with chronic diseases,and to explore the relationship between anxiety and depression in order to provide help for the relief of anxiety and depression in elderly patients with chronic diseases.METHODS The study used data from the 2011 Survey of anxiety and Depression symptoms among the elderly in Beijing.A total of 877 samples were obtained from the screening of chronic diseases diagnosed by "medical treatment"and "physical examination"among the elderly over60 years old.Binary Logistics regression was used to analyze the influence of related variables on anxiety and depression in elderly patients with chronic diseases.RESULTS There were 272 male and 439 female patients with depression in the control group,with an average age of(71.00±6.90)years old,and 57 male and 109 female patients in the case group,with an average age of(70.00±7.07)years old.There was no significant difference between the two groups in gender(χ~2=0.882,P=0.348)and age(t=1.167,P<0.05).There were 294 males and 434 females in the control group,with an average age of(71.00±6.95)years old,and 26 males and 92 females in the case group,with an average age of(69.00±6.24)years old.There were statistically significant differences in gender(χ~2=14.540,P<0.001)and age(t=2.931,P=0.01)between the two groups.Younger age(95%CI:0.635~0.890,P=0.001),more illness(95%CI:1.151-1.364,P<0.001)and less relative support(95%CI:0.938-0.984,P=0.001)were risk factors for depression in elderly patients with chronic disease.Young age(95%CI:0.641-0.961,P=0.019),low literacy(illiteracy:95%CI:1.537-11.911,P=0.005;Junior middle school:95%CI:1.277-7.080,P=0.012),more cases(95%CI:1.120-1.362,P<0.001)and less relative support(95%CI:0.944-0.995,P=0.022)were risk factors for anxiety in elderly patients with chronic diseases.CONCLUSION The lower the age is,the lower the level of education is,the less the relatives with close contact are,the worse the psychological anxiety and depression of the elderly patients with chronic diseases are.