Co-Morbidities Associated with Prematurity in Two Referral Hospitals in Cameroon

Introduction: Prematurity is the leading cause of neonatal death in Africa. More than a million children die each year due to co-morbidities related to prematurity. In addition to being one of the causes of neonatal deaths, the health problems associated with prematurity can also lead to severe lifelong impairment in those who survive. Objectives: This paper aims to determine the epidemiology and identify co-morbidities of prematurity in the neonatology units of the Douala General Hospital (DGH) and the Laquintinie Hospital of Douala (LHD). Patients and Methodology: We conducted an analytical retrospective cohort study from January 2015 to January 2018 in the neonatology department of the GDH and the LHD, which are considered reference hospitals for the management of preterm babies in Cameroon. We included all newborns aged less than 37 weeks admitted to the neonatology units of the GDH and the LHD. The descriptive component was based on the analysis of quantitative variables using measures of central tendency. The analytical component was evaluated using Spearman correlations and the Chi-square and Fisher tests. Simple and multiple logistic regressions measured factors predictive of mortality. The Kaplan Meier survival curve used the Log Rank test and significance at p ≤ 0.05. Results: We recorded 908 preterm newborns in neonatal service and 1,124 preterm deliveries in maternity, representing an incidence of 32.5% in neonatal unit and 10.6% in maternity. 51% of whom were girls, given a sex ratio M/F of 0.9. Hypertension was the main prenatal pathology (9.1%), while premature rupture of membranes: PROM (35.5%) and eclampsia/pre-eclampsia (18.6%) were the most common obstetrical pathologies. 75.9% of deliveries were vaginal with 65.2% being performed in our referral hospitals. Gestational age ranged from 22 to 36 weeks, with a mean of 32.4 weeks. Late preterm birth rate was 53.7%, and birth weight varied between 590 and 3200 g with an average of 1747 ± 479 g. The percentage of low birth weight (1500 - 2499 g) preterm infants was predominant (65.3%), and the intrauterine growth restriction (IUGR) was estimated to be 12.4%. The majority (96.7%) had pathologies in the neonatal period, the most common being neonatal infection (86.9%). The case-fatality rate was 27.4%, compared to 72.6% live births. Factors influencing mortality are risk of premature labour, gestational age ≤ 32 SA, premature birth in hospitals other than our two referral hospitals, birth weight ≤ 1500 g, Apgar at the 10th minute, late secondary anaemia, hospital resuscitation, oxygen therapy, and duration of hospitalization Conclusion: The incidence of prematurity and the mortality rate remains high in neonatal units in Cameroon. Adequate monitoring of pregnancies and management of preterm infants remains a challenge in our context.

Treatment of psychological co-morbidities in common gastrointestinal and hepatologic disorders

Anxiety and depressive disorders frequently coexist with gastrointestinal and hepatologic conditions.Despite their high prevalence,approach to treating these co-morbidities is not always straightforward.This paper aims to review the current literature into etiology of psychological comorbidities and their treatment in three conditions commonly encountered at gastroenterology outpatient clinics,namely inflammatory bowel disease(IBD),irritable bowel syndrome(IBS) and chronic hepatitis C(HepC).The paper demonstrates that although psychotherapy(and cognitive-behavioural therapy in particular) has been established as an effective treatment in IBS,more studies are needed in HepC and IBD.Antidepressants have been recognized as an effective treatment for psychological and somatic symptoms in IBS and for depression in HepC,but good quality studies in IBD are lacking despite the promising preliminary findings from animal models and case studies.Further studies in this area are needed.

Univariate and multivariate analysis of risk factors for severe clostridium difficile-associated diarrhoea: Importance of co-morbidity and serum C-reactive protein

AIM: To investigate risk factors for severe clostridium difficile associated diarrhoea (CDAD) in hospitalised patients. METHODS: We analysed risk factors for severe CDAD (associated with systemic signs of hypovolemia) in 124 hospitalised patients by retrospective chart review. RESULTS: Severe CDAD was present in 27 patients (22%). Statistical analysis showed a significant association with a higher 30-d mortality (33% vs 4%, P < 0.001) and a higher proportion of longer hospital stay exceeding 14 d (74% vs 52%, P = 0.048). Charlson co-morbidity score (OR 1.29 for 1 point increment, P < 0.05) and serum C-reactive protein at diagnosis (OR 1.15 for 10 mg/L increment, P < 0.001) were independent predictors of severe CDAD. CONCLUSION: Patients with a severe level of co- morbidity and high serum C-reactive protein levels at the time of diagnosis should receive particular attention.

Reconsidering Co-Morbid Traits in Explanatory Models of High Dental Anxiety Using a Comparison of Psychiatric and Normal Patient Samples

Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.

Population-based study of health service deficits in US adults with depression: Does chronic disease co-morbidity and/or rural residency make a difference?

Introduction: Rural residents are at higher risk for a depressive disorder than their non-rural counterparts. Recent research has indicated that co-morbidities are also associated with depression. Health service deficits (HSDs) is an analytic concept that facilitates the examination of how a population uses health services relevant to their condition. A HSD is present when, over the preceding 12 months, an individual has had no health insurance, no specified health care provider, deferred medical care due to cost, or did not have a routine medical exam. Research has shown a high prevalence of HSDs in populations with individual chronic conditions. No study that we know of has examined if there is an association between the constellation of chronic conditions of depression and the co-morbidities of asthma, arthritis, and diabetes, with HSDs. Methods: 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) data were analyzed to identify important dimensions of the epidemiology of depression by ascertaining whether there were differences in the prevalence of health service deficits in rural versus non-rural adults with depression and at least one additional chronic disease (arthritis, asthma, or diabetes). Data analyses entailed both bivariate and multivariate techniques. All analyses were performed on weighted data. Results: Logistic regression analysis performed using the presence of at least one HSD as the dependent variable yielded that for US adults with lifetime depression those who were African American, Hispanic and other/multiracial in comparison to Caucasian had higher odds of having at least one health service deficit. Low socioeconomic status (SES) and middle SES in comparison to high SES were also risk factors for US adults with lifetime depression having at least one HSD. Rural residency in comparison to non-rural residency also emerged as an independent risk factor (for US adults with lifetime depression having at least one HSD. Chronic disease, however, emerged as protective against US adults with lifetime depression having at least one health service deficit. Conclusions: This study demonstrated that race/ethnicity, SES, and rural residency are important predictors of health service deficits for individuals with a lifetime diagnosis of depression while having one or more chronic conditions for these same individuals was protective.

Preliminary Investigation of Sex Differences in Procedural Skill Learning in Veterans with Co-Morbidities

Sex differences in procedural skill learning have not been well characterized. Skill learning is an important area to explore in clinical settings that involve rehabilitation and deficit remediation, especially for returning Veterans that have a range of co-morbid conditions (traumatic brain injury, posttraumatic stress disorder, and depression) and possess impairments in multiple domains. Sixty-five (55 males, 10 females) Veterans completed two procedural learning tasks and answered self-report questionnaires. Participants’ performance and total learning slope were analyzed to determine sex differences in learning. Our results revealed sex differences in both tasks demonstrating females tend to perform better than males with a large effect size for these mean differences. While females performed better on the procedural learning tasks compared to males, their rate of learning was equivalent. Skill learning is an important requisite for rehabilitation, as skill learning is necessary to perform daily activities in new settings. Ultimately, these results provide insight into skill learning in Veterans with a range of co-morbid conditions and provide support for further investigation of sex differences in procedural learning.

A Physician Suffering from COVID-19 with Multiple Co-Morbidities Have Delayed Viral Clearance: A Case Report from Bangladesh

Background: Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. Case Report: A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.

Metabolic co-morbidities and psoriasis: The chicken or the egg?

Accumulating evidence supports that psoriasis may be a potential multisystem inflammatory disease associated with a range of co-morbidities showing an overlapping pathology and an important health impact such as metabolic diseases.Psoriasis is associated with an increased risk of obesity,metabolic syndrome(Mets)and diabetes mellitus type 2,following a"dose-response"relationship from mild to severe psoriasis.Conversely,recent evidence from large prospective studies suggests that obesity constitutes a risk factor for psoriasis and psoriatic arthritis.Also,a dyslipidemic profile may precede psoriasis onset.Both obesity,Mets and psoriasis,characterized as chronic inflammatory states,stem from a shared underlying pathophysiology exhibiting common genetic predisposition and risk factors such as high caloric intake,physical inactivity and psychological stress.Excess weight may potentiate the inflammation of psoriasis through the deregulation of adipocytokines while,at the same time,it may help the development of Mets.Interestingly,recent translational data has shown that psoriasis,through increased T-helper inflammatory cytokines in skin and sera,may exert a plethora of effects on insulin regulation and lipid metabolism.Largerpopulation-based prospective cohort and longitudinal studies are needed to unravel the association between psoriasis and metabolic co-morbidities.The recognition of the intricate complex interplay between psoriasis and metabolic co-morbidities may help dermatologists to be aware of associated metabolic co-morbidities in order to screen for metabolic diseases and manage holistically and effectively the psoriatic patient.

Psychiatric Co-Morbidity and Quality of Life in Egyptian Type 2 Diabetic Patients

Background: Diabetes is a risk factor for depression, but little is known about anxiety and other psychiatric disorders and quality of life. The aim of this study was to assess the prevalence of depression, anxiety in diabetic patients in our locality and to assess the quality of life in type 2 DM. Subjects & Methods: This study was a cross-sectional study and was carried out in outpatient clinics of specialized medical hospital, Mansoura university for a period of one year. From 217 diabetes mellitus subjects, only 202 patients were matched with 247 healthy people as a control group. All subjects were examined by using socioeconomic data, clinical data, and anthropometric examinations to assess body mass index and waist circumference. All patients were interviewed by using the Mini-International Neuropsychiatric Interview (MINI) version 5, MINI, Hospital Anxiety and Depression scale (HAD) and health-related quality of life (HRQOL) scales. Laboratory investigation in the form of fasting and two-hour postprandial blood sugar (FBS & 2hpp) and HbA1C levels were done. Results: 18.3% were found to be major depressive disorder;and 2.5% panic disorder, 1% other phobia. Generalized anxiety disorder and obsessive-compulsive disorder were found in one patient, no patients were found to be diagnosed as Bipolar disorder, schizophrenia, or substance abuse. Although there was no statistically significant difference between subjects and control groups regarding height, there was statistically significant difference between weights, BMI, with more scores among DM group. Moreover our study showed that HbA1c, fasting blood sugar, two hours post prandial blood sugar were more among DM patients and control groups. Anxiety, depression, and poorer quality of life were found to be more prevalent among DM patients than control groups. Conclusion: DM is associated with depression anxiety disorder with poorer quality of life.

The association between body composition and self-reported co-morbidity in subjects with chronic obstructive pulmonary disease

Background: Differences in body composition are extensively investigated in subjects with COPD as low muscle mass was independently associated with increased morbidity and mortality. Also cardio-vascular co-morbidity is often reported in COPD and the contribution of fat mass in COPD related co-morbidity is gaining interest. We hypothesized that the prevalence of low muscle mass and high fat mass is higher in subjects with COPD compared to a group of current and former smokers without COPD, which result in higher reported cardiovascular co-morbidity in the COPD group. Methods: In 954 subjects with COPD and 955 subjects without COPD, body composition was assessed by bio-electrical impedance analysis and information on self-reported co-morbidity was collected. Participants were stratified for low fat free mass index and high fat mass index (resp. fat free mass index 50th percentile of the subjects without COPD). Results: Subjects with COPD were more likely to have low fat free mass index than current and former smokers without COPD. The prevalence of high fat mass index was comparable between the groups. The percentage of self-reported co-morbidity was higher in subjects with COPD, but only reports of myocardial infarction were disease specific. Conclusion: Low fat free mass index was more common in COPD, but the prevalence of high fat mass index was comparable between subjects with and without COPD. Nevertheless, subjects with COPD reported more myocardial infarction, implying that other factors than the amount of fat mass are involved in the increased co-morbidity in COPD.

Incidence of Diabetes in Hepatitis C Patients in Remote Areas of Pakistan:Effect of Co-Morbidity on HCV Treatment Outcomes at Selected Secondary Care Hospitals

The management of Hepatitis C(HCV)varies greatly due to co-morbidities.Association of Type II Diabetes Mellitus(T2DM)and HCV infection is momentous,however,only limited studies available from remote areas of Pakistan.This study aimed to assess the incidence of T2DM in Hepatitis C patients,and to measure the treatment outcomes of anti-HCV therapy in co-morbidity of diabetic patients in remote areas of Khyber Pakhtunkhwa Pakistan.A cross-sectional retrospective analysis of HCV patients(n=449)was conducted in the District Hospitals of Bannu and Lakki Marwat,Pakistan.Patients diagnosed of HCV infection and having T2DM as comorbidity were included in the study.The demographic information and laboratory parameters,such as viral load(VL),hemoglobin(Hb),alanine amino transferase(ALT),and platelet count were collected to measure treatment outcomes.T2DM was found in 33.18%of patients and significant association(p˂0.05)was found with HCV infection as a co-morbidity.Sofosbuvir(SOF)and Ribavirin(RBV)therapy reduced the mean(SD)VL(×10^(3))from baseline 357.1±26.23 IU/mL to 14±2.3 IU/mL and 1.3±0.3 IU/mL at 3rd and 6th months of therapy,respectively.Conventional Interferon and Ribavirin(RBV)therapy reduced VL from a baseline 234.57±13.5 IU/mL to 72±7.9 IU/mL and 62±3.7 IU/mL at 3rd and 6th months of therapy,respectively.PEG-Interferon+Ribavirin(RBV)therapy reduced baseline VL from 337±16.27 IU/mL to 18±2.8 and 4±1 at 3^(rd) and 6^(th) month of therapy,respectively.Similarly,Hb,ALT,and platelet count showed variations in all the studied groups.T2DM was highly prevalent and significantly associated with HCV in patients of 40 years or above and SOF+RBV combination therapy showed a better response,both in the diabetic and non-diabetic HCV patients compared to earlier the therapies.To further confirm the finding,a study using a larger population of HCV patients with T2DM should be conducted.

Effect of awareness,quarantine and vaccination as control strategies on COVID-19 with Co-morbidity and Re-infection

In this paper,a deterministic compartmental model is presented to assess the impact of vaccination and non-pharmaceutical interventions(social distance,awareness,face mask,and quarantine)on the transmission dynamics of COVID-19 with co-morbidity and reinfection.An expression for the basic reproduction number is then derived for this model.Theoretical analysis shows that the model exhibits backward bifurcation phenomenon when the basic reproduction number is less than unity.But for the case of no reinfection,the model has a globally asymptotically stable disease-free equilibrium(DFE)when the basic reproduction number is less than unity.Furthermore,it is shown that in the case of no re-infection,a unique endemic equilibrium point(EEP)of the model exists which is globally asymptotically stable whenever the reproduction number is greater than unity.From the global sensitivity and uncertainty analysis,we have identified mask coverage,mask efficacy,vaccine coverage,vaccine efficacy,and contact rate as the most influential parameters influencing the spread of COVID-19.Numerical simulation results show that the use of effective vaccines with proper implementation of non-pharmaceutical interventions could lead to the elimination of COVID-19 from the community.Numerical simulations also suggest that the control strategy that ensures a continuous and effective mass vaccination program is the most cost-effective control strategy.The study also shows that in the presence of any co-morbidity and with the occurrence of re-infection,the disease burden may increase.

Dynamics of novel COVID-19 in the presence of Co-morbidity

A novel coronavirus(COVID-19)has emerged as a global serious public health issue from December 2019.People having a weak immune system are more susceptible to coronavirus infection.It is a double challenge for people of any age with certain underlying medical conditions including cardiovascular disease,diabetes,high blood pressure and cancer etc.Co-morbidity increases the probability of COVID-19 complication.In this paper a deterministic compartmental model is formulated to understand the transmission dynamics of COVID-19.Rigorous mathematical analysis of the model shows that it exhibits backward bifurcation phenomenon when the basic reproduction number is less than unity.For the case of no re-infection it is shown that having the reproduction number less than one is necessary and sufficient for the effective control of COVID-19,that is,the disease free equilibrium is globally asymptotically stable when the reproduction threshold is less than unity.Furthermore,in the absence of reinfection,a unique endemic equilibrium of the model exists which is globally asymptotically stable whenever the reproduction number is greater than unity.Numerical simulations of the model,using data relevant to COVID-19 transmission dynamics,show that the use of efficacious face masks publicly could lead to the elimination of COVID-19 up to a satisfactory level.The study also shows that in the presence of co-morbidity,the disease increases significantly.

高血压与幽门螺杆菌感染和维生素D缺乏共病研究进展

近年来,幽门螺杆菌感染在高血压患者的研究较多,发现幽门螺杆菌感染与高血压间存在关联,且治疗幽门螺杆菌感染对高血压的改善具有积极作用。维生素D是人体必需的营养素,它与骨骼代谢、钙磷平衡及心血管疾病密切相关。近期研究显示,血清维生素D水平与高血压间存在显著的相关性,维生素D的补充对高血压患者具有潜在的治疗价值。本文就幽门螺杆菌感染和维生素D缺乏与高血压的流行情况、国内外研究现状及其共病机制进行综述。

基于Wnt/β-catenin信号通路补肾活血中药治疗膝骨性关节炎与骨质疏松症“共病”机制研究进展

膝骨性关节炎(KOA)是一种膝关节慢性退行性病变,主要表现为关节疼痛、肿大、僵硬,对患者生活质量造成极大影响。骨质疏松症(OP)是一种全身性代谢性骨病,以骨量低下、骨微结构损坏为主要病理特征,易使患者发生骨折。中药具有多种有效成分,能多靶点、多功效治疗疾病,对治疗共病有极大优势。经典Wnt/β-catenin信号通路以多种途径调节膝关节软骨细胞形成与凋亡及骨细胞增殖和发育,与KOA与OP发病关系紧密。文章通过对补肾活血中药调控Wnt/β-catenin信号通路治疗KOA与OP“共病”的分子机制进行综述,为临床更有效、合理地使用补肾活血中药治疗KOA与OP“共病”提供依据。

基于象思维视域探讨冠心病伴抑郁因机治法

[目的]以气血为本探讨冠心病伴抑郁形神共病之因,以江河类比其病机并提出相应治则治法,最终达养形全神之效。[方法]以象思维为支点,将气血生成类比自然云雨转化,分析形神共病之因。以气血周流运行不畅类比江河之患,分析冠心病伴抑郁发病不同阶段的核心病因病机。并基于“流水不腐”这一自然现象,发掘冠心病伴抑郁的治疗与治水思想的异曲同工之处。[结果]自然之中阳化气成云,阴成形为雨,一如人体水谷气化与营气化血,气血互根互用,血气和利,方能形神相持。冠心病伴抑郁为形神共病,本质为气血失和,其核心病机虚、瘀、毒、郁互结,与江河之水的沉滞之患有相似之处。治疗此病需根据病变不同时期予以健脾补虚开源、活血化瘀疏浚、祛邪解毒净化及理气开郁泄洪之法,形神兼顾以达气血同调之功。[结论]通过援物比类的思维方式启发思路、触类旁通,使冠心病伴抑郁辨病辨证治疗化繁为简,使血气淖泽滑利,阴阳和调,亦是“圣人立象以尽意”的最终目的。

钠-葡萄糖共转运蛋白2抑制剂在老年2型糖尿病合并常见心血管疾病中的应用进展

老年2型糖尿病(T2DM)患者常有多病共存现象,而合并心血管疾病(CVD)最为常见,是其致残、致死的首要原因。钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)是一种新型降糖药物,其心血管保护作用受到广泛关注,在老年T2DM与CVD共病的治疗上展现出良好的前景。本文就SGLT2i在T2DM合并心力衰竭、高血压、动脉粥样硬化、心肌梗死等常见CVD中的应用研究进展作一综述。

Knee Arthroplasty Incidence Rate vs. Revision of Knee Arthroplasty and Its Associated Comorbidities in Colombia

Introduction: Total knee arthroplasty (TKA) has been established as a transformative solution in the treatment of advanced degenerative diseases of the knee, such as osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis. In this sense, TKA surgery, which seeks to replace the damaged joint with prosthetic components, has proven to be highly effective in relieving pain, improving joint function, and, ultimately, significantly increasing patients’ quality of life. The present study describes the TKA and revision knee arthroplasty (RKA) rates and, identifies the associated co morbidities in the Colombian context. Methods: A retrospective cohort study was carried out. It describes demographic and clinical characteristics between two groups of patients, TKA or RKA, and its association with mortality at 30 days, 90 days, or one year after the intervention. Results: The incidence rate of the population undergoing TKA was approximately 11.71 cases per 100,000 inhabitants. Furthermore, the incidence rate for revision knee arthroplasty (RKA) procedures in the same period was around 0.96 per 100,000 inhabitants. In both groups at 30 days postoperatively, a total mortality rate of 0.09%was recorded. When the follow-up was extended to 90 days, it increased to 0.15%;at one year postoperatively, it rose to 0.88%. Conclusion: Mortality after surgery was low in Colombia in 2019. Although RKA is a beneficial procedure, in certain circumstances, it was noted that it carries a higher risk compared to primary TKA. Our results emphasize the importance of careful evaluation of co morbidities and risk factors in patients undergoing these surgical procedures. The application of quality-of-life questionnaires should be considered in future studies on effectiveness and mortality for TKA and RKA in our country.

抑郁症患者自杀风险与共病数量、抑郁程度的相关性研究

目的探讨抑郁症患者共病的现状及自杀风险与共病数量、抑郁程度的关系。方法采用一般情况调查表、汉密尔顿抑郁量表(HRSD)、自杀意念自评量表(SIOSS)对湖北医药学院附属人民医院神经内科住院并愿意接受调查的125例抑郁症患者进行调查,按SIOSS评分标准分为自杀意念组(SIOSS≥12分)81例,非自杀意念组(SIOSS<12分)44例。结果抑郁症患者共病的前3位分别是失眠(87.2%)、头痛(69.6%)、腰背痛(66.4%);自杀意念组共病数量明显高于非自杀意念组,主要表现在失眠、头痛、腰背痛、焦虑症状(P<0.05);自杀意念组HRSD评分明显高于非自杀意念组,主要表现在认识障碍、睡眠障碍及绝望感(P<0.05);抑郁症患者自杀风险与共病数量、抑郁程度呈正相关(P<0.05),进一步进行多元线性逐步回归分析,受教育程度、共病数量及HRSD评分是抑郁症患者自杀的影响因素。结论抑郁症患者共病疾病中失眠与疼痛最多见,抑郁症自杀患者共病数量更多、睡眠更差、绝望感更强、认识障碍更严重。

心脑血管病患者焦虑抑郁状况调查

目的了解成都市综合医院心脑血管患者中焦虑、抑郁的患病情况,分析其影响因素。方法采用方便抽样从成都市抽取3个综合医院,同时连续抽样收集心内科确诊的冠心病患者152例,神经内科确诊的脑卒中患者100例。对医院焦虑抑郁量表(HAD)评分≥9分的患者由精神科医生使用Hamilton量表进一步确诊。结果调查对象抑郁症患病率为5.6%,焦虑症患病率为6.7%;92.9%抑郁患者同时患有焦虑症,76.5%的焦虑患者同时患有抑郁症;抑郁症患者均未曾被诊断为抑郁症并接受相应治疗,仅11.8%焦虑症患者曾被诊断为焦虑症并接受相应治疗;待岗或失业、自觉目前健康状况较差、工作较劳累为抑郁和焦虑的危险因素。结论焦虑和抑郁共患病率高,而焦虑和抑郁症诊断率和治疗率低。