社区全科门诊广泛性焦虑障碍患者生命质量及影响因素研究  

Quality of Life of Patients With Generalized Anxiety Disorder in Community General Practice Clinics and Its Influencing Factors

作　　者：杨华[1] 任利民[1] 劳力敏[1] 徐云霞[1] 蔡丞俊 陈华[2] 高键[3] 江孙芳[1] 祝墡珠[1] 

机构地区：[1]复旦大学附属中山医院全科医学科,上海市200032 [2]复旦大学附属中山医院心理科,上海市200032 [3]复旦大学循证医学中心

出　　处：《中国全科医学》2016年第4期414-417,436,共5页Chinese General Practice

基　　金：上海市公共卫生重点学科建设计划(12GWZX1001);上海市公共卫生人才培养计划(优秀学科带头人)(GWDTR201210)

摘　　要：目的了解社区全科门诊广泛性焦虑障碍(GAD)患者的生命质量,并探讨其影响因素。方法于2009年1月—2013年1月,采用广泛性焦虑量表(GAD-7)对到上海市6家社区卫生服务中心全科门诊就诊的5 841例患者进行GAD筛查,并采用简明国际神经精神访谈(MINI)[9]中的相关内容对阳性患者进行诊断。采用统一设计的调查表收集患者的一般资料,包括性别、年龄、文化程度、婚姻状况、工作状况、居住状况及慢性病患病情况等;采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对患者的焦虑、抑郁状况进行评估;采用健康调查量表(SF-36)对患者进行生命质量评估。结果患者的GAD筛查阳性率为4.8%(283/5 841),GAD检出率为2.9%(169/5 841)。将问卷填写完整的271例患者按诊断结果分为非GAD组(n=178)和GAD组(n=93)。两组性别、平均年龄、文化程度、婚姻状况及慢性病患病数量比较,差异有统计学意义(P<0.05);而工作状况和居住状况比较,差异无统计学意义(P>0.05)。两组HAMA评分和HAMD评分比较,差异有统计学意义(P<0.05)。两组SF-36中的生理功能、生理职能、躯体疼痛、总体健康、生命活力、社会功能、情感职能及精神健康8个维度评分比较,差异均有统计学意义(P<0.05)。多元线性逐步回归分析显示,文化程度对GAD患者生理功能、生理职能评分的影响有统计学意义(P<0.05);年龄对GAD患者生命活力评分的影响有统计学意义(P<0.05);HAMD评分对GAD患者生命活力和精神健康评分的影响有统计学意义(P<0.05)。结论社区全科门诊中GAD患者的生命质量较差,年龄、文化程度及抑郁状况是其影响因素。Objective To investigate the quality of life of patients with generalized Anxiety Disorder（ GAD） in community general practice clinics and its influencing factors. Methods From January 2009 to January 2013,5 841 patients who visited the general practice clinics of six community health service centers in Shanghai were screened with 7-Item Generalized Anxiety Disorder Scale（ GAD-7） and patients who showed positive results were diagnosed by Mini-International Neuropsychiatric Interview（ MINI）. Using a unified self-designed questionnaire,we collected the general information of the patients including gender, age, educational level, marital status, working condition, living condition and chronic diseases. Anxiety and depression of the patients were assessed by Hamilton Anxiety Scale（ HAMA） and Hamilton Depression Scale（ HAMD）. The quality of life of the patients was assessed by Health Survey scales（ SF-36）. Results The GAD positive rate of screening was 4. 8%（ 283 /5 841） and the GAD detection rate was 2. 9%（ 169 /5 841）. 271 patients who completed the questionnaire were divided into non-GAD group（ n = 178） and GAD group（ n = 93） according to the results of diagnosis. The two groups were significantly different in gender,average age,educational level,marital status and chronic diseases（ P 〈0. 05）. The two groups were not significantly different in working condition and living condition（ P 〉0. 05）. The two groups were significantly different in HAMA scores and HAMD scores（ P 〈0. 05）. The two groups were significantly different in the scores of 8 dimensions in SF-36 including physiological function,physiological role,body pain,general health,life vitality,social function,role of emotion and mental health（ P 〈0. 05）. Multiple linear stepwise regression analysis indicated that the influence of educational level on the scores of physiological function and physiological role of these patients was significant（ P 〈0. 05）; the influence of age on the score of

关 键 词：焦虑 全科门诊 生活质量 影响因素分析 

分 类 号：R749.72[医药卫生—神经病学与精神病学] R197[医药卫生—临床医学]