河北省脑血管病患者共病抑郁障碍的现况调查

Prevalence of Comorbid Depression with Cerebrovascular Disease in Hebei Province

背景抑郁障碍与脑血管病的患病率逐年升高,脑血管病共病抑郁障碍影响患者的康复,目前的研究多以脑血管病住院患者为研究对象,针对社区脑血管病患者共病抑郁障碍的研究鲜见。目的调查河北省社区脑血管病患者共病抑郁障碍的患病率及相关因素,为疾病预防与政策制定提供依据。方法 2016年4—8月采用多阶段分层整群随机抽样方法对河北省18岁及以上社区居民的精神障碍患病率及相关情况进行横断面调查。以自制一般情况调查问卷调查研究对象性别、年龄、居住地、精神疾病家族史、文化程度、职业、家庭年收入、婚姻状况、生活方式(吸烟、饮酒、饮茶、规律体育锻炼)、心理社会问题(是否存在群体支持问题、住房问题、经济问题、卫生保健服务问题)。以满足脑血管病诊断标准的被调查者为研究对象,根据是否符合抑郁障碍诊断将其分为脑血管病共病抑郁障碍组和脑血管病未共病抑郁障碍组。对脑血管病患者共病抑郁障碍的患病率及影响因素进行分析。结果符合脑血管病诊断的患者485例(2.32%),其中脑血管病共病抑郁障碍组56例(11.55%)、脑血管病未共病抑郁障碍组429例(88.45%)。脑血管病共病抑郁障碍组与脑血管病未共病抑郁障碍组性别构成、年龄分布、精神疾病家族史构成、家庭年收入分布、饮酒比例、饮茶比例、体育锻炼情况比较,差异有统计学意义(P<0.05)。脑血管病共病抑郁障碍组患者存在经济问题、卫生保健服务问题比例高于脑血管病未共病抑郁障碍组患者(P<0.05)。多因素Logistic回归分析发现,精神疾病家族史〔OR(95%CI)=0.177(0.061,0.520)〕、经济问题〔OR(95%CI)=0.184(0.093,0.365)〕、卫生保健服务问题〔OR(95%CI)=0.194(0.087,0.432)〕是脑血管病共病抑郁障碍的影响因素(P<0.05)。结论脑血管病患者共病抑郁障碍的风险高于一般人群,存在精神疾病家族史、经济问题、卫生保健服务问题可能是脑血管病共病抑郁障碍的影响因素。

Background The prevalence of depression and cerebrovascular disease is increasing year by year.Cerebrovascular disease comorbid depression affects the rehabilitation of patients.Current research mostly focuses on hospitalized patients with cerebrovascular disease.There are few studies on comorbid depression with cerebrovascular diseases in community.Objective To investigate the prevalence and related factors of comorbid depression in patients with cerebrovascular diseases in Hebei Province,provide a basis for disease prevention and policy development.Methods From April to August 2016,a multi-stage stratified cluster random sampling method was used to conduct a cross-sectional survey on the prevalence and related conditions of mental disorders among community residents aged 18 years and over 18 years in Hebei Province.A self-made general condition questionnaire was used to investigate the gender,age,place of residence,family history of mental illness,education level,occupation,family annual income,marital status,lifestyle(smoking,drinking,tea,regular physical exercise),psychosocial problems(whether there are group support problems,housing problems,economic problems,health care service problems).Respondents who meet the diagnostic criteria of cerebrovascular diseases were selected as the research objects.According to whether they met the diagnosis of depression,they were divided into cerebrovascular disease comorbid depression group and cerebrovascular disease non-comorbid depression group.The prevalence and related factors of comorbid depression in patients with cerebrovascular disease were analyzed.Results A total of 485 cases met the diagnosis of cerebrovascular diseases,including 56 cases of comorbid depression(11.55%).There were statistically significant differences on gender composition,age distribution,family history of mental illness,family annual income distribution,smoking ratio,drinking ratio,and physical exercise between the cerebrovascular disease comorbid depression group and the cerebrovascular disease non-comorbid depression group(P<0.05).The proportion of patients with cerebrovascular disease comorbid depressive disorder with economic problems and health care service problems was higher than that of patients with cerebrovascular disease without comorbid depression group,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis found that family history of mental illness〔OR(95%CI)=0.177(0.061,0.520)〕,economic problems〔OR(95%CI)=0.184(0.093,0.365)〕,health service problems〔OR(95%CI)=0.194(0.087,0.432)〕were independent risk factors of comorbid depression of cerebrovascular disease(P<0.05).Conclusion The risk of comorbidity depression in patients with cerebrovascular disease is higher than that in the general population.Family history of mental illness,economic problems,and health care service problems may be the influencing factors of comorbid depression in cerebrovascular disease.