北京部分综合医院门诊就诊者焦虑障碍的现况调查  

Prevalence of Anxiety Disorders in Outpatient Departments of General Hospitals in Beijing

作　　者：李家磊[1] 姜荣环[2] 马弘[2] 于欣[2] 党卫民[2] 白文佩[3] 刘梅颜[4] 魏镜[5] 何燕玲[6] 

机构地区：[1]云南省精神病院,云南省昆明市650224 [2]北京大学精神卫生研究所,卫生部精神卫生学重点实验室 [3]北京大学第一医院 [4]北京大学人民医院 [5]北京协和医院 [6]上海市精神卫生中心

出　　处：《中国全科医学》2013年第10期1173-1175,共3页Chinese General Practice

基　　金：首都医学发展科研基金(2009-2027)

摘　　要：目的了解北京部分综合医院门诊就诊者焦虑障碍的现况。方法以医院为基础进行横断面调查,选取三所三级甲等综合医院的心血管科、消化科、神经科和妇科门诊为研究点,以指定调查日内年龄≥18岁、意识清楚、能独立回答问题并知情同意的就诊者为调查对象,顺序纳入。患者完成一般问卷、医院焦虑抑郁量表(HADS)的自评筛查;就诊科室医生在不了解筛查结果的情况下独立完成诊疗;精神科医师对HADS≥8分的筛查阳性者进行国际神经精神科简式访谈问卷(M.I.N.I.)的诊断性评估。对于已知情同意并完成筛查,但是拒绝精神科医生诊断性检查的就诊者按失访处理。结果实际完成调查的就诊者共2 074例。经失访校正后的焦虑障碍现患率为7.6%(157/2 074),男性为6.5%(43/661),女性为8.1%(114/1 399),性别间差异无统计学意义(P>0.05);其中广泛性焦虑障碍为2.8%(59/2 074),场所恐惧症为1.7%(35/2 074),特定恐怖症为1.4%(29/2 074),惊恐障碍为1.1%(23/2 074),社交恐惧症为1.1%(23/2 074),强迫障碍0.6%(12/2 074),混合性焦虑抑郁障碍为0.6%(12/2 074;87.3%(137/157)的就诊者只患有一种焦虑障碍。经失访校正后的终身患病率为8.7%(180/2 074),男性为7.6%(50/661),女性为9.3%(130/1 399),性别差异无统计学意义(P>0.05);其中,广泛性焦虑障碍为2.8%(59/2 074),场所恐惧症为2.2%(45/2 074),惊恐障碍为2.1%(43/2 074),特定恐怖症为1.4%(29/2 074),社交恐惧症为1.1%(23/2 074),强迫障碍0.6%(12/2 074),混合性焦虑抑郁障碍0.6%(12/2 074);84.4%(152/180)的焦虑障碍患者只患有一种焦虑障碍。结论焦虑障碍是三级综合医院就诊者中的常见问题,男女患病率间无明显差异,且以广泛性焦虑障碍诊断居多,大多数患者只患有一种焦虑障碍。Objective To explore the prevalence of anxiety disorders in outpatient departments of a part of general hos- pitals in Beijing. Methods A hospital - based cross - sectional study was conducted. The subjects were recruited from the three Third- Level Grade -A hospitals, who visited the cardiology, gastroenterology, neurology and gynecology outpatient depart- ments, and who aged 18 or over, were conscious and with informed consent, and can finish the questionnaire independent- ly. They finished the general questionnaire and Hospital Anxiety and Depression Scale （HADS） . The subjects with HADS score of 8 or over were surveyed and diagnosed with Mini International Neuropsychiatric Interview （MINI） by psychiatrists. All the sub- jects, who refused to receive diagnostic examination by psychiatrists, were treated as the case of loss of follow - up. Results A total 2 074 subjects were included in the survey. The adjusted prevalence rate of MINI - diagnosed anxiety disorder was 7.6% （ 157/2 074）, and there was no significant difference between male and female [ 6.5% （43/661） vs 8.1% （ 114/1 399） ~ （ P 〉0. 05 ） . Among them the prevalence of general anxiety disorder, agoraphobia, specific phobia, panic phobia, social phobia and compulsive -obsessive disorder was 2. 8% （59/2 074）, 1.7% （35/2 074）, 1.4% （29/2 074）, 1.1% （23/2 074）,1.1% （23/2 074）, 0.6% （ 12/2 074）, 0. 6% （ 12/2 074）, respectively. And 87. 3% （ 137/157 ） suffered from only one kind of anxiety disorders. The adjusted prevalence rate of lifetime anxiety disorder was 8. 7% （ 180/2 074）, and there was no gen- der difference [ 7.6% （50/661） for male and 9. 3% （130/1 399） for female~ （P 〉 O. 05 ） . The adjusted prevalence of lifetime general anxiety disorder, agoraphobia, specific phobia, panic phobia, social phobia and compulsive -obsessive disorder was 2.8% （59/2 074）, 2. 2% （45/2 074）, 2. 1% （43/2 074）, 1.4% （29/2 074）, 1.1% （23/2 074）, 0.6% （12/2074）, 0. 6% （ 1

关 键 词：焦虑障碍 患病率 综合医院 门诊 横断面调查 

分 类 号：R749.2[医药卫生—神经病学与精神病学]