中国临床心理学杂志

综合医院门诊病人焦虑、抑郁与躯体症状的关联研究

单位：1. 广东省人民医院广东省医学科学院广东广州 510080
2 广东省卫生厅广东广州 510060
3. 南方医科大学

分类号：R395.1

出版年,卷(期):页码：2009,17(4):462-464

摘要：

目的：探讨广州地区综合医院门诊就诊者的焦虑、抑郁症状及与躯体症状的关系。方法：通过随机抽样从广州市卫生局抽取广州15家综合医院，采用医院焦虑抑郁量表(HADS)和病人健康问卷(PHQ-15)对1842例综合医院普通门诊就诊者进行量表评定。结果：1842例门诊病人中，焦虑、抑郁及焦虑、抑郁合并现患率分别为14.0%、10.2%、17.8%；躯体症状与焦虑、抑郁的相关分析显示，PHQ-15总分、PHQ-15阳性症状数目与HADS总分、HAD-A因子分及HAD-D因子分呈显著正相关；以躯体症状轻微(PHQ-15，0-4分)组作为参考值，计算不同程度躯体症状患者焦虑、抑郁患病相对危险度，结果显示，轻度(PHQ-15，5-9分)、中度(PHQ-15，10-14分)、重度(PHQ-15，15-30分)躯体症状患者焦虑患病的相对危险度RR(95%CI)分别为2.90(1.94-4.33)、8.32(5.40-12.81)、23.05(12.72-41.77)；抑郁患病的相对危险度RR(95%CI)分别为2.37(1.52-3.68)、6.98(4.38-11.13)、9.86(5.18-18.77)；焦虑、抑郁合并患病的相对危险度RR(95%CI)分别为2.80(1.98-3.96)、8.11(5.53-11.89)、18.12(10.26-32..03)。结论：综合医院门诊就诊者焦虑、抑郁常见；躯体症状与焦虑、抑郁密切相关，躯体症状程度越重，躯体症状数目越多，焦虑、抑郁越明显，焦虑、抑郁患病相对危险度越高。

Objective: To investigate the prevalence of anxiety and depressive symptoms and to analyse the relationship between anxiety, depression and somatic symptoms in outpatients in general hospitals. Methods: By way of a cross sectional survey, 1842 outpatients from 15 general hospitals in Guangzhou, China, were tested with Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire (PHQ-15). Results: The prevalence rates of anxiety and/or depressive symptoms were 14.0%, 17.8%, 10.2% respectively in outpatients in Guangzhou. Significant correction was observed between HADS and PHQ -15 scores (r 0.374 -0.481, P<0.01). Compared with patients with minimal somatic symptom severity(PHQ-15 scores=0-4), the Relative Risk (RR)(95%CI) for anxiety and/or depression in patients with low PHQ-15 scores(5-9) were 2.90(1.94-4.33), 2.80(1.98-3.96), 2.37(1.52-3.68) respectively; in patients with medium PHQ- 15 scores(10-14) were 8.32(5.40-12.81), 8.11(5.53-11.89), 6.98(4.38-11.13) respectively; in patients with high PHQ-15 scores(15-30) were 23.05(12.72-41.77), 18.12(10.26-32.03), 9.86(5.18-18.77) respectively. Conclusion: There is high prevalence of anxiety and/or depression in outpatients in general hospitals. Also significant correlation was observed between anxiety, depression and somatic symptoms.

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作者简介：

参考文献：

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