上海市嘉定区社区康复期抑郁症患者压力状况及影响因素分析

Analysis on the stress status and influential factors of depression patients in community rehabilitation in Jiading District,Shanghai GAO Cunyou,CONG Enzhao,GUO Benyu,et al. Jiading District Mental Health Center,Shanghai 201803,China

目的了解社区康复期抑郁症患者心理压力状况及影响因素,为下一步开展复发预防康复工作提供参考依据。方法选取上海市嘉定区135名社区康复期抑郁症患者为研究组,设156名健康志愿者为对照组。采用精神压力分析仪分析心理压力水平,应用自编成长问卷(GSIS)、简易应对方式问卷(SCSQ)、个人自评问卷(PEI)调查社会心理影响因素。结果与对照组比较,研究组创伤史分值偏高,兴趣爱好、心理储备、社会支持分值偏低,差异有统计学意义(P<0.01或0.05);研究组心率变异指标LF/HF值、消极应对分偏高,HF值和LF值、积极应对分、PEI总分及其主要因子分均偏低(P<0.01或0.05)。LF/HF与兴趣爱好、心理储备、社会支持、积极应对、PEI总分及其部分因子呈著负相关,与消极应对呈正相关(P<0.01或0.05)。心理储备、消极应对、社会支持、积极应对和PEI的f7因子(总体自信水平)进入多元回归方程。结论社区康复期抑郁症患者心理压力状况不容忽视,积极开展心理健康教育、改善社会支持状况,提高患者自我应对能力与自信心有利于预防抑郁症的复发。

Objective To explore the stress status and influential factors of depression patients in community rehabilitation,and provide a reference for the development of targeted measures to prevent recurrence. Methods A total of 135 community-based rehabilitation patients with depression in Jiading District of Shanghai were enrolled in this study. The psychological stress analysis instrument was used to analyze the psychological stress level. The General status invested score(GSIS),Simple Coping Style Questionnaire(SCSQ)and Personal Self-Assessment Questionnaire(PEI)to investigate the social-psychological factors. Results Compared with the control group,the score of trauma history in the study group was higher,while the scores of interest,psychological reserve and social support were lower(P<0.01 or 0.05);the index of heart rate variability(HRV)LF/HF,negative coping were higher,and the scores of HF,LF,positive coping,PEI and main factors were lower(P<0.01 or 0.05). LF/HF was negatively correlated with hobby,psychological reserve,social support,positive coping,PEI total score and some factors,and positively correlated with negative coping(P<0.01 or 0.05). Multiple stepwise regression analysis showed that psychological reserve,negative coping,social support,positive coping and PEI’s f7 factor(overall confidence level)entered the regression equation. Conclusion Psychological stress in patients with depression during community-based rehabilitation should not be overlooked. It is necessary to carry out comprehensive interventions to improve patients’ psychological reserve,social support,and improve self-coping ability and self-confidence.