综合医院心理门诊患者短期治疗依从性研究  

Therapy compliance of outpatients at the medical psychological center of a general hospital

作　　者：黄晓琴[1] 陈玉玲[2] 严小蓉[2] 章洋[2] 

机构地区：[1]安徽医科大学第一附属医院医学心理科,合肥230022 [2]安徽医科大学第一附属医院门诊部,合肥230022

出　　处：《安徽医科大学学报》2006年第4期475-478,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的观察综合医院心理门诊常见病患者治疗依从性。方法对522例符合入组标准的初诊患者门诊随访记录2个月以上,按照依从性标准观察。其中抑郁症231例,焦虑症89例,强迫症119例,精神分裂症83例。均符合CC-MD-3诊断标准,另外抑郁症患者汉密顿抑郁量表(HAMD17)≥18分。结果总体依从性差者占41.2%;依从性与年龄、婚姻、职业和诊断显著相关(P<0.05),依从性差的疾病依次为:抑郁症(51.5%)、焦虑症和强迫症(38.2%和37.0%)、精神分裂症(21.7%);精神分裂症依从性好于抑郁症(P<0.001),也好于焦虑症和强迫症(P<0.05)焦虑症、强迫症依从性好于抑郁症(P<0.05),差于精神分裂症(P<0.05)焦虑症和强迫症之间依从性差异无显著性(P>0.05)。结论不同的精神疾病治疗依从性不同;抑郁症患者门诊治疗依从性较低,需改变治疗策略,提高治疗依从性。Objective To investigate clinical therapy compliance of outpatients at the medical psychological center of a general hospital. Methods 522 outpatients including depre-ssion 231, anxiety disorder 89, obsessive-compulsive disorder（OCD） 119, and schizophrenia 83, who all meet the CCMD-3 criteria, were followed up. In the depression group, the patients whose scores were under 18 points assessed by Hamilton Depression Scale （HAMD17-item） were excluded. Each patient was successively observed for 2 months. Results Total noncompliance rate was 41.2 %. There was a significant correlation between compliance and age （P 〈 0.05 ）, marriage （P 〈 0. 01 ）, profession（P 〈0.01 ） and diagnosis（P 〈0. 001 ） respectively. The rate of noncompliance was 51.5% in the depression group, 38.2% and 37.0% in the anxiety disorder and OCD group, and 21.7% in schizophrenia group. The compliance in the schizophrenia group was better than that in depression group（ P 〈 0. 001 ）, and anxiety disorder or OCD （ P 〈 0. 05 ）, which were better than that in the depression group （ P 〈 0.05 ） ; There were no significan differences in compliance between anxiety disorder and OCD. Conclusion There are different compliances with treatment in various mental disorder, and the compliance of depression is poor. We should improve tactics in order to increase the compliance with treatment for depression.

关 键 词：病人依从 精神障碍/心理学 医院 综合 门诊医疗 心理疗法 短期 

分 类 号：R749.05[医药卫生—神经病学与精神病学] R197.323[医药卫生—临床医学]