综合医院消化科门诊抑郁焦虑障碍患者的社会功能损害  

The Disability of Social Function of Gastrointestinal Outpatients with Depressive or Anxiety Disorders in General Hospitals

作　　者：张玲[1] 何燕玲[2] 马弘[3] 刘哲宁[4] 贾福军 李晓靖[1] 张岚[1] 

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]上海交通大学医学院附属精神卫生中心 [3]北京大学精神卫生研究所 [4]中南大学附属湘雅二院精神卫生中心 [5]广东省精神卫生中心

出　　处：《华西医学》2015年第8期1469-1472,共4页West China Medical Journal

摘　　要：目的了解消化科门诊抑郁障碍和焦虑障碍患者的社会功能损害。方法 2007年5月-6月在全国13家医院采用多中心、横断面的研究对1 995例综合医院消化科门诊患者使用医院焦虑抑郁量表(HADS)进行筛查,由精神科医生对HADS≥8分且同意进入访谈的患者使用国际神经精神科简式访谈问卷确诊有无抑郁障碍或焦虑障碍,使用Sheehan残疾量表评估患者的健康状况对生活、工作、社交的影响,同时记录患者半年内因本次症状或疾病的就诊次数及每月误工时间,采用Mann-Whitney U检验,比较抑郁焦虑障碍组(病例组)与无抑郁焦虑障碍组(对照组)的功能损害、就诊次数及误工时间,并进一步分别比较功能性消化科疾病患者组内与器质性消化科疾病患者组内的病例组和对照组患者的社会功能损害的差异。结果病例组的健康状况对生活、工作、社交影响的评分均高于对照组,差异有统计学意义(P<0.05)。病例组的就诊次数及误工时间均多于对照组,差异有统计学意义(P<0.05)。功能性消化科疾病患者组内病例组与对照组比较,病例组的健康状况对生活、工作、社交影响的评分均高于对照组,差异有统计学意义(P<0.05);病例组的就诊次数及误工时间均多于对照组,差异有统计学意义(P<0.05)。器质性消化科疾病患者组内病例组与对照组比较,病例组的健康状况对生活、工作、社交影响的评分均高于对照组,差异有统计学意义(P<0.05);两组在就诊次数方面差异无统计学意义(Z=-1.337,P=0.181),病例组误工时间多于对照组(Z=-4.307,P<0.001)。结论对于功能性消化科疾病患者和器质性消化科患者,抑郁障碍和焦虑障碍都会影响患者的社会功能,消化科患者的抑郁焦虑障碍应该得到重视。Objective To explore the disability of social function of gastrointestinal outpatients with depressive or anxiety disorders in general hospitals. Methods A multicenter cross-sectional study was conducted from May to June in 2007. A total of 1 995 subjects from 13 general hospitals in China were screened by using the Hospital Anxiety and Depression Scale （HADS）. The subjects scored ≥ 8 on HADS were diagnosed via the Mini International Neuropsychiatric Interview by psychiatrists. The Sheehan Disability Scale （SDS） was used to assessed patients＇ disability of life, work, and social intercourse aspects. Then, compared the subjective quality of life, number of doctor visits, and monthly loss of working days between outpatients with and without depressive or anxiety disorders in last six months. Further, compared the social dysfunction between patients with depression/anxiety disorders （the case group） and without depression/anxiety disorders （the control group） in functional disorders group and organic disease group of gastroenterology respectively. Results In comparison to the control group, the case group had much higher score of SDS, including life, work, and social intercourse （P 〈 0.05） aspect and had more doctor visits and loss of more working days （P 〈 0.05）. In functional disorders group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse （P 〈 0.05） aspect and had more doctor visits, loss of more working days （P 〈 0.05） compared with those in the control group. In organic disease group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse （P 〈 0.05） aspect and had loss of more working days （Z=-4.307, P 〈 0.001） compared with those in the control group. Conclusion For the patients with functional disorders or organic disease of gastroenterology, the depressive and anxiety disorders may lead to the disability of social function.

关 键 词：消化科门诊患者 抑郁障碍 焦虑障碍 生活质量 

分 类 号：R749.7[医药卫生—神经病学与精神病学]