抑郁焦虑评估对胃肠道恶性肿瘤患者术后抑郁焦虑症状及心理卫生机构就诊率的影响  

Impact of depression and anxiety assessment performed in gastrointestinal cancer patients on postoperative depression and anxiety symptom and mental health service visit

作　　者：孙宸[1] 周岩冰[1] 王东升[1] 陈栋[1] 李宇[1] 曹守根[1] 焦学龙[1] 

机构地区：[1]266071,青岛大学附属医院普通外科

出　　处：《中华胃肠外科杂志》2016年第5期571-574,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨抑郁焦虑评估对胃肠道恶性肿瘤患者术后抑郁焦虑症状及心理卫生机构就诊率的影响。方法回顾性分析2014年8月至2015年1月期间在青岛大学附属医院普通外科接受手术治疗的254例胃肠恶性肿瘤患者的临床资料。根据患者是否接受围手术期精神评估分为评估组（121例）和对照组（133例）。评估组采用患者健康问卷抑郁量表（PHQ．9）及广泛性焦虑量表（GAD．7）分别在入院时、出院时及随访3月时进行抑郁焦虑评估；对照组仅在随访3月时进行上述评估。采用美国临床肿瘤学会发布的指南所提供的分界线（设定PHQ．9评分≥8分为抑郁，GAD．7评分≥5分为焦虑），采用χ2检验或Fisher精确概率法以及Mann—WhitneyU检验比较两组患者术后3月随访时的抑郁和焦虑评分以及心理卫生机构的就诊率。结果根据PHQ．9和GAD．7评分，评估组入院时抑郁发病率为28．9％（35／121），焦虑发病率为37．2％（45／121），同时患有抑郁和焦虑的患者占9．9％（12／121）。在术后3月的随访中，评估组的PHQ．9评分（6．02±4．67）和GAD．7评分（4．19±3．95）均低于对照组（分别为8．83±6．63和6．41±5．80），差异有统计学意义（均P〈0．05）。评估组和对照组患者术后于心理卫生机构就诊比例分别为10．7％（13／121）和3．0％（4／133），差异有统计学意义（χ2=9．726，P=0．014）。结论抑郁和焦虑在胃肠道恶性肿瘤患者中发病率较高。对胃肠恶性肿瘤患者常规进行抑郁焦虑评估，能够提高心理卫生机构的就诊率，改善其术后抑郁和焦虑症状，进而提高生活质量。Objective To investigate the impact of depression and anxiety assessment performed in gastrointestinal cancer patients on postoperative depression and anxiety symptom and mental health service visit. Methods A total of 254 gastrointestinal eancer patients who underwent surgical procedure were assigned into assessment group （n = 121） and control group （n = 133）. Depression and anxiety assessment were performed with PHQ-9 and GAD-7 in assessment group on admission, discharge and at 3-month follow-up while in control group only at 3-month follow-up. The point prevalence of depression and anxiety were evaluated in assessment group with established cut-off reported by ASCO defining depression as a PHQ-9 score no less than 8 and anxiety as a GAD-7 score no less than 5. PHQ-9 and GAD-7 scores at 3-month follow-up were compared using Mann-Whitney U test. Results According to the P.HQ-9 and GAD-7 score, the prevalence of depression was 28.9% （35/121） and anxiety was 37.2% （45/121） in assessment group, and depression was found in 9.9%（12/121） with comorbid anxiety. During the 3-month follow-up, the PHQ-9 and GAD-7 score in assessment group （6.02 ±4.67 and 4.19 ± 3.95） were both lower than those in control group （8.83 ± 6.63 and 6.41 ± 5.80） with statistically significant differences （all P 〈 0.05）. Patients in assessment group were more likely to seek for help in mental health service than those in control group [10.7%（13/121） vs. 3.0%（4/133）, X2 = 9.726, P = 0.014] in 3- month follow-up after surgery. Conclusions The prevalence of depression and anxiety is high in gastrointestinal cancer patients. Depression and anxiety assessment routinely performed for gastrointestinal cancer patients can enhance utilization of mental health service and reduce postoperative depression and anxiety symptom thus potentially improve quality of life.

关 键 词：胃肠肿瘤 抑郁 焦虑 心理卫生机构 

分 类 号：R735[医药卫生—肿瘤]