城市社区卫生服务站就诊患者的抑郁情绪及症状表达  

Depressive symptom in urban primary care patients

作　　者：李琳[1] 范海楠[1] 方瑜[2] 余湘娥[1] 刘丽婷[1] 陈树林[1] 

机构地区：[1]浙江大学心理与行为科学系,杭州310028 [2]安徽医科大学临床医学系,合肥230032

出　　处：《中国心理卫生杂志》2013年第1期18-22,共5页Chinese Mental Health Journal

摘　　要：目的:探讨城市社区卫生服务站就诊患者中抑郁的严重状况和抑郁症状的表达及相关因素,了解抑郁症状在不同人口学特征个体中的分布状况,为社区医生识别抑郁患者提供建议。方法:选取杭州市社区卫生服务站就诊患者2571人,用病人健康问卷抑郁量表(PHQ)进行调查。结果:15.4%的患者存在抑郁症状,其中轻、中度抑郁占10.8%,重度抑郁占4.6%。存在抑郁症状的患者中,过去2周内至少一半以上时间出现躯体症状的平均人数比多于出现精神症状的人数比(56.5%vs.44.4%)。有序logistic回归分析结果表明,离异或丧偶、较低的受教育年限、非全职、对经济状况不满意的就诊患者抑郁程度较重(OR=1.95、1.90、1.46、2.08、2.90)。结论:本研究提示,在社区卫生服务站就诊的患者中存在抑郁症状的比率较高。不满意的婚姻、较低的受教育程度、非全职和对经济的不满意可能与出现抑郁症状相关。有抑郁的患者存在较多躯体症状主诉,但也存在兴趣丧失和情绪低落主诉。Objective： To explore the depressive symptom and the related factors in urban primary care patients, and to provide advice for identifying depression to primary care clinicians. Methods： Totally 2571 patients were selected and assessed with the Patient Health Questionnaire Depression Module （PHQ）. Results： 15.4% of all the participants had depressive symptoms. Among those with depressive symptoms, 10. 8% were mild or moderate, 4. 6% were severe. The proportion of depressed patients who reported physical symptoms presented more than half days in the past 2 weeks was larger than those who reported mental symptoms （56. 5% vs. 44. 4% ）. Ordinal logistic regression showed that the divorced or widow, ones with lower education level or part-time job, and dissatisfied with their economy had severer depressive symptoms （ OR = 1.95, 1.90, 1.46, 2. 08, 2. 90; Ps 〈 0.05）. Conclusion： It suggests that the rate of depressive symptoms in patients visiting the primary care may be higher. Unhappy mar- riage, lower education, part-time job and being dissatisfied with their economy might be the risk factors for depressive symptoms. The depressed patients have more physical complaints, as well as the complaints of lost interest and depressed emotion.

关 键 词：抑郁症状 抑郁严重程度 人口学变量 横断面研究 

分 类 号：R749.4[医药卫生—神经病学与精神病学]