综合医院不同科室门诊多躯体症状患者抑郁、焦虑障碍的检出率及症状分布特点——一项多中心横断面研究

摘要

目的:描述综合医院不同科室门诊中多躯体症状患者的躯体、抑郁和焦虑症状分布特点及抑郁障碍、焦虑障碍检出率.方法:对国内6个综合医院中医科、西医内科和精神/心理科门诊候诊患者连续筛查,并完成简明国际神经精神障碍访谈(MINI).结果:本研究共纳入491例受试者,其中多躯体症状组(SOM+)237例(48.3%).SOM+患者最常受困扰的抑郁症状为疲劳和睡眠问题等;其抑郁或焦虑障碍的检出率为50.4%.此外,尽管躯体症状严重程度相似,在心理科就诊的SOM+患者抑郁或焦虑障碍的检出率更高(34.6%,43.9%,76.2%;χ2=17.1,P<0.01).结论:综合医院门诊多躯体症状患者中抑郁或焦虑障碍的检出率较高;疲劳和睡眠问题是多躯体症状患者中最常见症状.%Objective:To explore the distribution of somatic,depressive and anxious symptoms in Chinese outpatients with multiple somatic symptoms (SOM+)in general hospitals,as well as their comorbidity with de-pression and anxiety disorders in different medical settings. Method:This multi-centered cross-sectional study was conducted in outpatient clinics of traditional Chinese medicine (TCM),western internal medicine, and psychiatry/ psychological medicine. Patients in the waiting list were screened continuously and invited to complete the mini international neuropsychiatric interview (MINI). Results:Of the 491 included patients, 237 (48. 3%)among them were SOM+. For patients in SOM+ group,the most frequently selected troubling symptoms were fatigue and sleeping problems;and the current detectable rate of depression or anxiety disorders was 50. 4%. In addition,the detectable rate of depression or anxiety disorders in SOM+ patients from psychoso-matic medicine departments was significantly higher than that in TCM or western internal medicine departments (73. 5%,24. 2%,30. 2%;χ2 =17. 1,P<0. 01),even though the severity of somatic symptoms was similar. Conclusion:Fatigue and sleeping problems were the most common depressive symptoms in Chinese outpatients with multiple somatic symptoms in general hospitals;50. 4% general hospital outpatients with multiple somatic symptoms in China were comorbid with depression or anxiety disorders;patients with comparable somatic symp-toms severity would seek help from psychosomatic medicine when they felt depressive and anxious.