Fava半定式访谈工具在中国抑郁和焦虑障碍患者中的运用  

Application of Fava＇s semi-structured interview questionnaire in Chinese patients with depressive disorder and anxiety disorder

作　　者：李磊[1] 张钰群[1] 杜向东[2] 沈鑫华[3] 杨忠 石元洪 刘瑞[6] 王桥[6] 吴爱勤[7] 袁勇贵[1] 

机构地区：[1]东南大学附属中大医院心理精神科,南京210009 [2]苏州大学附属广济医院精神科,苏州215000 [3]浙江省湖州市第三人民医院精神科,湖州313000 [4]常熟市精神卫生中心精神科,常熟215500 [5]苏北人民医院心理科,扬州225000 [6]东南大学信息科学与工程学院,南京211100 [7]苏州大学附属第一医院精神科,苏州215000

出　　处：《中华行为医学与脑科学杂志》2016年第9期807-811,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：江苏省重点医学人才项目（RC2011121）

摘　　要：目的应用Fava半定式访谈工具（DCPR）筛查中国抑郁和焦虑障碍人群中符合DCPR症状的发生率及其症状分布情况；并比较A型行为量表（TABP）、多伦多述情障碍量表（TAS-20）、简式健康焦虑量表（SHAI）与DCPR对相关症状的识别率是否存在差别。方法使用中文版Fava半定式访谈工具、17项汉密尔顿抑郁量表（HAMD）及14项汉密尔顿焦虑量表（HAMA）对110例抑郁障碍患者和41名焦虑障碍患者进行评定，并与上述3个自评量表的症状发生率进行比较。结果151例患者中，只有7例（4．6％）无DCPR症状，39例（25．8％）存在1个DCPR症状者，存在5个以上DCPR症状者为33例（21．85％）。述情障碍[83例（55．0％）]、沮丧[56例（37．1％）]、A型行为有[53例（35．1％）]和易激惹[37例（24．5％）]最常见；抑郁和焦虑障碍患者只在周年反应的发生率上差异有统计学意义（16．4％和34．1％，P〈0．05）。HAMA与DCPR症状数量存在有统计学意义的相关性（r=0．167；P=0．041）。DCPR与TAS-20诊断的述情障碍发生率差异无统计学意义（Х^2=2．069，P=0．150）；DCPR与TABP诊断的A型行为发生率差异有统计学意义（Х^2=15．532，P=0．000）；DCPR与SHAI诊断的健康焦虑发生率差异有统计学意义（Х^2=13．056，P=0．000）。结论95．4％的抑郁和焦虑障碍患者存在1个或以上DCPR症状，中文版TAS-20与DCPR对述情障碍的识别率无统计学意义的差别。Objective To study the prevalence of Fava＇s semi-structured diagnostic criteria for psychosomatic research（DCPR） clusters in a Chinese sample meeting the DSM-IV criteria for depressive disorder or anxiety disorders, and the association between three DCPR syndromes and three Chinese version scales ,which are Toronto Alexithymia Scale （TAS-20） ,Type A Behavior Patem Scale （TABP） and Short Heahh Anxiety Inventory （SHAI）. Methods 110 inpatients with depressive disorders and 41 with anxiety disorders were recruited. All subjects were administered the Chinese version of the semi-structured interview for DCPR, Hamilton depression scale （HAMD） and Hamilton anxiety scale （HAMA）, and the prevalence of DCPR symptoms were compared with TAS-20,TABP and SHAI. Results 7 subjects （4.6%） did not satisfy the criteria for any DCPR syndrome, 39 subjects （25.8%） had one DCPR diagnosis, and 33 subjects （21. 85%） had more than 5 DCPR syndromes. The 4 most common syndromes were alexithymia （83,55.0%）, demoralization （ 56,37.1% ）, Type A behavior （ 52,35.1% ） , and irritable mood （ 37,24.5% ）. The prevalence of anniversary reaction in anxiety disorders （34.1% ） was significantly different with that in depressive disorders （ 16.4% ）. There was no significant difference between alexithymia prevalence diagnosed by DCPR and by TAS-20. The prevalence of type A behavior diagnosed by DCPR was significantly different from by TABP （ Х^2 = 15.532, P= 0.000）. The prevalence of DCPR diagnosed health anxiety was significantly different from SHAI diagnosed （Х^2= 13.056, P= 0.000）. Conclusion 95.4% patients with depression or anxiety receive at least one DCPR diagnosis. TAS-20 and DCPR have high consistency in alexithymia diagnosis.

关 键 词：Fava半定式访谈工具 抑郁障碍 焦虑障碍 述情障碍 A型行为 

分 类 号：R749[医药卫生—神经病学与精神病学]