躯体症状障碍患者抗抑郁药治疗依从性的影响因素分析

Analysis of influencing factors on antidepressants compliance of patients with somatic symptoms disorder

目的对影响躯体症状障碍(SSD)患者抗抑郁药物治疗依从性的因素进行分析。方法前瞻性纳入符合标准的SSD患者147例,根据MMAS-8评分分成依从性好组(41例)、依从性中等组(64例)、依从性差组(42例),分别比较3组间性别、年龄、文化程度、居住地、生活满意度、经济状况、社会支持度、自知力、发病时间、症状严重程度、共病情况、合并症情况、治疗效果、不良反应、医患关系是否存在差异。结果3组间性别、文化程度、发病时间比较差异无统计学意义(P>0.05),而年龄、居住地、生活满意度、经济状况、社会支持度、自知力、症状严重程度、共病情况、合并症情况、治疗效果、不良反应和医患关系比较差异有统计学意义(P<0.05,P<0.01)。Logistic分析显示,生活满意度高、社会支持度良好、有自知力、症状严重程度较重、治疗效果良好是影响治疗依从性的保护因素,有合并症、不良反应较重是影响治疗依从性的危险因素。结论生活满意度高、社会支持度良好、有自知力、症状严重程度较重、治疗效果良好会提高SSD患者的治疗依从性,有合并症、不良反应较重则会降低治疗依从性。

Objective To analyze the factors affecting the antidepressant compliance of patients with somatic symptoms disorder(SSD).Methods A total of 147 patients with SSD were prospectively enrolled,thay were divided into three groups according to Morisky Medication Adherence Scale(MMAS-8)score:good compliance group(41 cases),medium compliance group(64 cases)and poor compliance group(42 cases),the differences of sex,age,education,residence,life satisfaction,economic status,social support,insight,onset time,symptom severity,comorbidity,complication,treatment effect,adverse reaction and doctor-patient relationship among the three groups were compared.Results There were no significant differences in sex,education level and onset time among the three groups(P>0.05),there were significant differences in age,residence,life satisfaction,economic status,social support,insight,symptom severity,comorbidity,complication,treatment effect,adverse reaction and doctor-patient relationship(P<0.05,P<0.01).Logistic analysis showed that high life satisfaction,good social support,self-insight,severe symptoms and good treatment effect were the protective factors of treatment compliance,complications and severe adverse reactions were risk factors for treatment compliance.Conclusion High life satisfaction,good social support,insight,severe symptoms,good treatment results will improve the treatment compliance of SSD patients,however,complications,adverse reactions will reduce treatment compliance.