综合医院门诊焦虑障碍患者的特点分析

摘要

Objective To explore the characteristics of anxiety disorder in outpatient of general hospitals. Methods The outpatients in Neurology,Gastroenterology,Cardiology,and Gynecology department were screened using general information questionnaire,Hospital Anxiety and Depression Scale( HADS),Patient Health Questionnaire somatic symptom severity scale (PHQ - 15). All the patients who's HADS score were 8 or above were examined by psychiatrists using the Mini International Neuropsychiatry Interview(MINI)and were determined the psychiatric diagnosis. Results All in all 2 074 outpatients completed the investigation:110 with anxiety disorder(anxiety disorder group)among which 57(51. 8% )with comorbid anxiety depres-sion,1 538 cases without anxiety disorder(normal group)(915 cases' HADS were under 8,623 cases were determined by MINI). The depression group was younger than the normal control〔(45. 3 ± 14. 1)vs. (49. 7 ± 16. 8),t = 2. 667,P 0. 05).The total score in PHQ - 15 of anxiety patient were higher than those of normal controls〔(12. 5 ± 5. 7)vs. (7. 1 ± 4. 3),t =12. 371,P 0.05）。焦虑障碍组的 PHQ -15总分为（12.5±5.7）分，正常组为（7.1±4.3）分，两组间比较差异有统计学意义（t =12.371，P <0.01）。焦虑障碍组患者 PHQ -15中出现频率前三位的条目为：感到疲劳37.3%（41例）；睡眠问题37.3%（41例）；虚弱感30.0%（33例）。正常组和焦虑障碍组的误工天数、目前疾病造成的功能损害（对家庭生活和家庭责任的影响、对工作和学习的影响、对社交生活的影响）间差异有统计学意义（P <0.05）。焦虑障碍组患者有自杀倾向者占32.7%（36例），只有22例患者（20.0%）被建议转诊到精神科（16例，14.5%）或予以精神类药物（6例，5.5%）。结论综合医院门诊的焦虑障碍患者共病抑郁障碍的比例高、躯体主诉多、生活质量差、自杀倾向高，但被识别的比例较低。