神经科和精神科门诊抑郁障碍患者的临床和就诊特点  

Clinical characteristics and hospital choice in depressive patients from general hospital and psychiatric hospital

作　　者：马红梅[1] 唐登华[1] 王效敏[1] 

机构地区：[1]北京大学精神卫生研究所心理治疗科,北京市100083

出　　处：《中国组织工程研究与临床康复》2007年第30期5965-5967,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:比较综合医院神经科和精神专科医院门诊抑郁障碍患者的临床特点和就诊特点。方法:分别选择首次就诊于世纪坛医院神经科门诊的47例(综合医院组)和北大精神卫生研究所门诊的65例抑郁障碍患者(专科医院组),采用自编调查表和汉密顿抑郁量表(HAMD-17)调查。自编调查表资料包括年龄、性别、婚姻状况、居住地、病程、首发年龄、个性特征、月收入、就医途径(首诊医院)、前3位主诉、对疾病认识、医疗费用(从患者发病开始计起至调查日止,让患者及家属尽量回忆充分)。汉密顿抑郁量表包含17项,采用0～4分的5级评分法:0无,1轻度,2中度,3重度,4很重。结果:112例患者均完成量表测试和调查,全部进入结果分析。①87%的综合医院组的抑郁障碍患者第一主诉为躯体不适;57%专科医院组的抑郁障碍患者第一主诉为情绪低落。②94%的综合医院组患者首诊选择综合医院;42%的专科医院组患者首诊选择综合医院。③综合医院组汉密顿抑郁量表评分低于专科医院组,属于中度抑郁;而专科医院组基本为重度抑郁。综合医院组患者汉密顿抑郁量表总评分及迟滞和认知障碍的因子分显著低于专科医院组患者,差异有显著性意义。④83%的综合医院组患者认为自己所患不是精神疾病;39%的专科患者认为自己所患为精神疾病。⑤两组在年龄、文化程度、婚姻状况、既往史等方面也有显著差异。结论:综合医院抑郁障碍患者较专科医院患者年龄偏大、多伴有躯体疾病,抑郁程度相对较轻,对情绪问题的自知力差。AIM： To compare clinical characteristics and hospital choice of depressive patients in general arid psychiatric hospitals. METHODS： Totally 47 depressive patients in Department of Neurology, Shijitan Hospital （general hospital group） and 65 depressive patients in Mental Health Institute, Peking University （psychiatric hospital） were investigated with serf-made inventory and Hamilton Depression Scale （HAMD-17）. Serf-made inventory included age, gender, marriage, habitation place, course, first-onset age, personality, month income, first-choice hospital, first three complaints, recognition to disease and medical cost （from onset to investigation day, and the patients and their family members fully recalled）. HAMD included 17 items, rating from 0-4 points： 0 represented none, 1 represented mild, 2 as moderate, 3 as severe and 4 as extremely severe. RESULTS： Totally 112 patients received the scale and investigation and were involved in the result analysis. （1）87% depressive patients in general hospital presented with somatic complaints. 57% depressive patients in psychiatric hospital presented with depression. （2）94% depressive patients in general hospital chose general hospital in seeking health service the first time. 42 % depressive patients in psychiatric hospital chose general hospital in seeking health service the first time. （3）Score of HAMD in depressive patients in general hospital was lower than that of depressive patients in psychiatric hospital, referring to moderate depression. But it showed severe depression in the psychiatric hospital. Total score of HAMD of depression and factors of retardation and cognitive dysfunction of depressive patients in general hospital was lower than that of depressive patients in psychiatric hospital. There were significant differences. （4） 83% depressive patients in general hospital thought they had not psychiatric disease. 39% depressive patients in psychiatric hospital thought they had a psychiatric disease. （5）There were signi

关 键 词：抑郁障碍 就诊机构 主诉 

分 类 号：R749.3[医药卫生—神经病学与精神病学]