综合医院门诊焦虑障碍患者的特点分析  

Characteristics of Anxiety Disorder in General Hospitals' Outpatient Department

作　　者：鲁文兴 陈星[2] 姜荣环[3] 马弘[4] 娄英男 何燕玲[6] 杨蕾[7] 

机构地区：[1]普洱市第二人民医院,云南省665000 [2]江苏省南通市第四人民医院 [3]解放军总医院医技部医学心理科,解放军医学院医技部医学心理科 [4]北京大学第六医院,北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学) [5]中国人民解放军第三军医大学 [6]上海市精神卫生中心 [7]空军航空医学研究所附属医院

出　　处：《中国全科医学》2014年第31期3748-3751,共4页Chinese General Practice

基　　金：首都医学发展科研基金(2009-2027)

摘　　要：目的了解综合医院门诊焦虑障碍患者的就诊特点。方法于2007年5—6月对北京市三所综合医院神经内科、消化内科、心内科和妇科的门诊患者进行调查。采用一般筛查问卷、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)、患者健康问卷(patient health questionnaire somatic symptom severity scale,PHQ-15)进行筛查,对HADS评分≥8分的就诊者由经过培训的精神科医师采用国际神经精神科简式访谈问卷(the mini international neuropsychiatric interview,MINI)进行精神状况检查,并做出精神科诊断。结果共有2074人完成调查,其中诊断为焦虑障碍者(焦虑障碍组)110例,其中57例(51.8%)共患抑郁障碍;无精神障碍者(正常组)1538例(HADS评分<8分者915例,经MINI诊断无精神障碍者623例)。焦虑障碍组的平均年龄为(45.3±14.1)岁,正常组为(49.7±16.8)岁,两组年龄间差异有统计学意义(t=2.667,P<0.05);两组性别、职业间差异无统计学意义(P>0.05)。焦虑障碍组的PHQ-15总分为(12.5±5.7)分,正常组为(7.1±4.3)分,两组间比较差异有统计学意义(t=12.371,P<0.01)。焦虑障碍组患者PHQ-15中出现频率前三位的条目为:感到疲劳37.3%(41例);睡眠问题37.3%(41例);虚弱感30.0%(33例)。正常组和焦虑障碍组的误工天数、目前疾病造成的功能损害(对家庭生活和家庭责任的影响、对工作和学习的影响、对社交生活的影响)间差异有统计学意义(P<0.05)。焦虑障碍组患者有自杀倾向者占32.7%(36例),只有22例患者(20.0%)被建议转诊到精神科(16例,14.5%)或予以精神类药物(6例,5.5%)。结论综合医院门诊的焦虑障碍患者共病抑郁障碍的比例高、躯体主诉多、生活质量差、自杀倾向高,但被识别的比例较低。Objective To explore the characteristics of anxiety disorder in outpatient of general hospitals. Methods The outpatients in Neurology,Gastroenterology,Cardiology,and Gynecology department were screened using general information questionnaire,Hospital Anxiety and Depression Scale（ HADS）,Patient Health Questionnaire somatic symptom severity scale （PHQ - 15）. All the patients who＇s HADS score were 8 or above were examined by psychiatrists using the Mini International Neuropsychiatry Interview（MINI）and were determined the psychiatric diagnosis. Results All in all 2 074 outpatients completed the investigation：110 with anxiety disorder（anxiety disorder group）among which 57（51. 8% ）with comorbid anxiety depres-sion,1 538 cases without anxiety disorder（normal group）（915 cases＇ HADS were under 8,623 cases were determined by MINI）. The depression group was younger than the normal control〔（45. 3 ± 14. 1）vs. （49. 7 ± 16. 8）,t = 2. 667,P 〈0. 05〕,and there was of no significant difference between the two groups on gender and occupation distribution（ P 〉 0. 05）.The total score in PHQ - 15 of anxiety patient were higher than those of normal controls〔（12. 5 ± 5. 7）vs. （7. 1 ± 4. 3）,t =12. 371,P 〈 0. 01〕. The most common chief complaints were tiredness,sleep problem and weakness and the occurrence fre-quency was 37. 3% （41）、37. 3% （41）、30. 0% （33）separately. The days of absent from work in anxiety patients were more than those of normal control（P 〈 0. 05）,and the impairment on work,life and social functions was also higher in anxiety patients（P 〈 0. 05）. Total 32. 7% （36）anxiety patients had suicide idea or attempts,and among which 22 cases（20. 0% ） were recommended consulting psychiatric department（16 cases,14. 5% ） or taking antipsychotic drugs（6 cases,5. 5% ）. Conclusion Outpatients with anxiety disorder in general hospitals had a high frequency of depression co - morbidity,with many somatic complaints,poor life q

关 键 词：焦虑障碍 医院 综合 门诊患者 临床特点 

分 类 号：R749.72[医药卫生—神经病学与精神病学]