综合医院内科门诊躯体疾病患者抑郁焦虑障碍患病率的调查

摘要

Objective To describe the prevalence of illness-depressive and anxiety disorders(general medical condition)of internal medicine outpatient departments in different levels of general hospitals in Shenyang and to compare to the prevalence of the gender differences.Methods Stratified multi-stage cluster randomization was used to identify 23 general hospitals for investigation,a total 5312 internal medicine outpatients above 15 years of age in outpatient departments have been investigated.The researcher used expanded version of General Health Questionnaire(GHQ-12)as a screen instrument to identify subgroups of the sample at high,moderate and low risk,then psychiatrists determined their diagnosis by using structured clinical interview for DSM-Ⅳ Axis I Disorders-Patient Edition(SCID-I/P)for 100%of high-risk and 40%of moderate-risk and 10%of low-risk subjects.Results In Shenyang internal medicine outpatient departments,the prevalence of any illness-depressive and anxiety disorders wasl.02%(95%CI:0.77%～1.35%).Illness-depressive was 0.55%(95%CI:0.38%～0.81%)and illness-anxiety was 0.47%(95%CI:0.31%～0.71%).Illness depressive and anxiety in the males was(1.42%,95%CI:0.97%～2.08%)higher than females(0.77%,95%CI:0.51%～1.17%).RR valne was 1.85(95% CI:3.36%～1.05%).Level 1 hospitals 2.04%(95%CI:1.27%～3.27%)was highest than level 2 and level 3.Conclusion The prevalence of illness-depressive and anxiety disorders in females was lower than males in internal medicine outpatients,and level 1 hospitals was highest than level 2 and level 3.%目的 探讨综合医院内科门诊缘于躯体状况的抑郁、焦虑障碍患病率,并在不同性别、不同级别医院之间进行比较.方法 采用分层随机整群抽样方法共抽取沈阳市23家三个级别综合医院进行调查,共调查5312例年龄15岁及以上的内科门诊病人.调查员在病人就医内科医生前使用扩展的一般健康问卷(GHQ-12)作为筛查工具,然后由精神科医生使用DSM-Ⅳ定式临床检查(SCID-I/P)对筛选高、中、低危险组100%、40%、10%的调查对象进行SCID诊断.结果 沈阳市综合医院内科门诊病人缘于躯体状况的抑郁焦虑障碍总患病率为:1.02%(95%CI:0.77%～1.35%).抑郁障碍0.55%(95%CI:0.38%～0.81%),焦虑障碍0.47%(95%CI:0.31%～0.71%).男性缘于躯体状况的抑郁焦虑障碍患病率(1.42%,95%CI:0.97%～2.08%)高于女性(0.77%,95%CI:0.51%～1.17%).RR值为1.85(95%CI:3.36%～1.05%).一级医院缘于躯体的抑郁焦虑障碍患病率2.04%(95%CI:1.27%～3.27%)高于二级医院(0.99%,95%CI:0.62%～1.59%)和三级医院0.65%,95%CI:0.38%～1.09%).结论 沈阳市综合医院内科门诊缘于躯体状况的抑郁焦虑障碍患病率男性高于女性,一级医院高于二级和三级医院.