综合医院神经内科住院患者焦虑/抑郁状况的多中心研究  

A multiple center study on depression and anxiety state in the department of neurology

作　　者：张菁[1] 魏镜[2] 史丽丽[1] 李舜伟[1] 王艳云[3] 陈嘉峰[4] 许晶[5] 桂冰[6] 刘力[7] 吴哲[8] 王惠君[9] 吴凯[10] 张忠玲[11] 张国红[12] 谷金素[13] 宋本华[14] 许兰萍[15] 

机构地区：[1]中国医学科学院 中国协和医科大学 北京协和医院 心理医学科,100730 [2]中国医学科学院 中国协和医科大学 北京协和医院心理医学科,100730 [3]北京天坛医院神经内科 [4]吉林大学第一临床医院神经内科 [5]辽宁省大连医科大学附属第一临床医院神经内科 [6]辽宁省大连市中心医院心理科 [7]北京海淀医院神经内科 [8]中国医科大学第一附属医院神经内科 [9]河北医科大学第一附属医院神经内科 [10]北京医院神经内科 [11]哈尔滨医科大学附属第一医院神经内科 [12]河北医科大学第二临床医院神经内科 [13]北京世纪坛医院神经内科 [14]黑龙江齐齐哈尔市第一医院神经内科 [15]北京朝阳医院神经内科

出　　处：《中华医学杂志》2007年第13期889-893,共5页National Medical Journal of China

摘　　要：目的探讨综合医院神经内科住院患者焦虑/抑郁状况的发生率及健康相关的生活质量。方法使用医院焦虑抑郁量表(HADS)、汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)和简明健康状况调查表(SF-36)对综合医院神经内科住院患者在入院时(48h 之内)和出院时(48 h 之内)分别进行评估,以了解这些患者的情感状况和健康状况相关的生活质量。结果共有610例患者完成了入院时的评估,入院时具有临床意义的抑郁症状(HAMD≥18分)和焦虑症状(HAMA≥14分)的患者分别为123例(20.2%)和161例(26.4%),此284例中有96例同时达到具有临床意义的抑郁和焦虑状态。405例患者完成了出院时的评估,出院时有具有临床意义的抑郁症状(HAMD≥18分)和焦虑症状(HAMA≥14分)的患者分别为68例(16.8%)和93例(23%),此161例中有52例同时达到有临床意义的抑郁和焦虑状态。以入院时 SF-36量表总分作为因变量的多元回归分析显示:性别、焦虑、抑郁与健康状况相关的生活质量相关。住院期间对有临床意义的患者进行药物治疗的为59例(20.8%)。药物治疗组和非治疗组比较在出院时 HAMA 和 HAMD 总分下降;活力,情感职能和精神健康等分数反映健康相关的生活质量增加。结论神经内科住院患者的焦虑抑郁发生率较高,焦虑和抑郁情感对患者的健康相关的生活质量有影响,单纯治疗躯体疾病并不能缓解焦虑和抑郁情感,且患者的焦虑抑郁从负面影响患者对于躯体疾病治疗结局的评价,应该对合并焦虑、抑郁情感的神经内科住院患者给予抗抑郁和抗焦虑的治疗。Objective Inpatients of 15 general hospitals were investigated in order to understand the incidence of depression and anxiety state and the patients＇quality of life in the Department of Neurology. Methods We used Hospital Anxiety and Depression scale （ HADS）, 17-item Hamilton Rating Scale for Depression （HAMD）, Hamilton Rating Scale for Anxiety （HAMA） and 36-item Short Form Health Survey （SF-36） as tools to evaluate inpatients＇ emotional state and health related quality of life within 48 hours after admitted and before discharge, respectively. Results 610 inpatients were finished admitted evaluation, patients showed clinical depressive symptoms and anxiety symptoms were 123 （ 20. 2% ） and 161 （ 26.4% ） respectively , in which including 96 showed the both. 405 inpatients finished discharge evaluation, patients showed clinical depression symptoms and anxiety symptoms were 68 （ 16. 8% ） and 93 （23%） respectively, in which including 52 showed the both. Regression analysis indicated that health related quality of life was associated with gender, anxiety and depression state. Only 59 （ 20. 8% ） patients received drug treatment during they admitted. There were statistic significance decrease of the HAMA and HAMD total scores between treatment group and non-treatment group when discharged; Vitality, role of emotional and mental health were significantly increacd at the time of discharge. Conclusion High rate of depression and anxiety state occurred in the department of Neurology. These abnormal emotions affected the quality of life of patients. If a physician treated somatic diseases only, the depressive and anxiety disturbances could not be remission. Thus, more attention should be paid to give adequate treatment if a patient concomitant presented the emotional disturbances in the general hospital.

关 键 词：医院科室 住院病人 焦虑 抑郁障碍 生活质量 

分 类 号：R749[医药卫生—神经病学与精神病学]