甘肃地区心血管疾病住院患者焦虑抑郁状态单中心调查

A single-center survey on anxiety and depression in hospitalized patients with cardiovascular diseases in Gansu Province

目的对因心血管疾病住院患者的焦虑抑郁状态进行调查研究,分析其影响因素。方法随机抽样法选取2018年9月1日至2019年5月30日于兰州大学第一医院心内科住院患者1180例,均来自甘肃省不同地、县(市),应用抑郁症状筛查量表(PHQ-9)、广泛性焦虑自评量表(GAD-7)进行评估,收集患者基础资料,运用有序Logistic回归分析相关性因素。结果①PHQ-9、GAD-7的Cronbrach’α系数分别为0.842、0.900,两者存在显著正相关性(r=0.727,P<0.001)。②1180例患者中,广泛性焦虑或/和抑郁症状者占比56.0%,单纯抑郁占13.8%,单纯焦虑占8.8%,焦虑合并抑郁占33.4%。其中,轻度焦虑(25.2%),中度焦虑(11.9%),重度焦虑(5.2%);轻度抑郁(26.0%),中度抑郁(13.3%),中重度抑郁(5.8%),重度抑郁(2.1%)。“感觉疲倦或没有活力”和“变得容易烦恼或急躁”分别是抑郁、焦虑最普遍的症状,有10.3%表示在过去2周里有不如死掉或用某种方式伤害自己的念头。③经多元有序Logistics回归分析,合并多种心血管疾病、女性、饮酒、低学历、低家庭收入是抑郁障碍的危险因素(P<0.05),女性、低学历是焦虑障碍的危险因素(P<0.05)。结论甘肃省心血管疾病患者焦虑抑郁发病率高达56%,以轻、中度为主,医护人员应重视患者的心理状态,做到早评估、早干预。

Objective To survey the status of anxiety-depression and analyze influence factors in patients hospitalized due to cardiovascular diseases.Methods The patients(n=1180)were chosen by using random sampling method from Department of Cardiology in the First Hospital of Lanzhou University from Sept.1,2018 to May 30,2019,who came from different districts and counties(cities)in Gansu Province.The patients were reviewed by using Patient Health Questionnaire-9 Items(PHQ-9)and Generalized Anxiety Disorder-7 Items(GAD-7).The basic data was collected from the patients,and correlation factors were analyzed by using ordinal Logistic regression analysis.Results①The Cronbrach’αcoefficient of PHQ-9 was 0.842 and that of GAD-7 was 0.900 and there was significant correlation between them(r=0.727,P<0.001).②Among 1180 patients,cases of generalized anxiety disorder or depression accounted for 56.0%,case of simple depression,for 13.8%,cases of simple anxiety,for 8.8%,and anxiety complicated by depression,for 33.4%.Of them,25.2%with mild anxiety,11.9%with moderate anxiety,5.2%with severe anxiety,26.0%with mild depression,13.3%with moderate depression,5.8%with moderatesevere depression and 2.1%with severe depression.“Feeling tired or no vitality”and“being easily annoyed or impatient”were the most common symptoms of respectively depression and anxiety.There were 10.3%patients with the intentions of death or hurting themselves somehow in past 2 weeks.The results of Logistics regression analysis showed that complicated multiple cardiovascular diseases,female,drinking,low academic qualification and low household income were risk factors of depression(P<0.05),and female and low academic qualification were risk factors of anxiety(P<0.05).Conclusion The incidence rate of anxiety-depression is as high as 56%mainly mild and moderate anxiety-depression in Gansu Province.Medical staff should pay attention to the psychological state of patients with cardiovascular diseases and make early assessment and early intervention.