抑郁症患者照料者心理负担及其影响因素研究

摘要

目的：探讨和评估抑郁症患者照料者的社会心理负担，调查其精神疾病共患情况，了解照料者社会心理负担与患者疾病严重程度的关系。方法：随机选取110例抑郁症患者和其主要照料者110例。抑郁症的诊断根据DSM-IV标准，并进行详细的体格检查及整体功能评估。对照料者进行半定式的临床访谈和查体，调查工具包括：运用照料者压力指数（CSI）和Zarit照料者负担量表（ZBI）评估照料者压力及其程度，汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评估照料者情绪。结果：抑郁症患者照料者负担与疾病严重程度有明显关系，并且重度抑郁患者（伴或不伴精神病性症状）的照料者有显著的焦虑和抑郁（P＜0．01）。患者总体功能量表评分与照料者负担呈显著负相关（P＜0．01）。照料者负担与患者住院次数、照料者年龄、照料者抑郁和焦虑严重程度及电休克治疗次数呈明显正相关（P＜0．01）。结论：影响抑郁症患者照料者的负担和精神疾病共患情况是多因素的，应对照料者提供更多的支持。%Objective :To investigate the extent of psychosocial burden and psychiatric morbidity among the caregivers of depressive disorder patients and to correlate the psychosocial burden of depressive disorder on caregivers with the disease severity .Methods :110 depressive mood disorder patients and 110 main caregivers were randomly selected .Pa-tients were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders ,4th ed .,text revision(DSM-IV) ,and followed by psychiatric and physical examination ,as well as global assessment of function for patients .Care-giverswereobjectedtothefollowingtools :(a)CaregiverStrainIndex(CSI)andZaritcaregiverburdeninventory(ZBI) to measure the degree of burden .Hamilton Anxiety Rating Scale(HAMA) and Hamilton Depression Rating Scale (HAMD) were conducted to detect the mood disorder .Results:Burden on caregivers were significantly higher among the severe type .Caregivers of patients with the severe type were found to have significant anxiety and depression .A strong negative correlation was found between the burden on caregivers and the severity of the clinical condition .Con-clusion:There are many factors affecting the degree of burden and psychiatric morbidity among caregivers of depressive disorder patients .Hence ,it is recommended that more support be introduced for caregivers .