急性白血病患者焦虑障碍的现况调查  

A cross-sectional investigation of anxiety disorder in acute leukemia patients

作　　者：曲姗[1] 陈育红[2] 许兰平[2] 张晓辉[2] 王昱[2] 胜利[3] 谢稚鹃[1] 

机构地区：[1]北京大学人民医院精神科,北京100044 [2]北京大学人民医院北京大学血液病研究所、造血干细胞移植治疗血液病北京市重点实验室,北京100044 [3]北京和睦家医院,北京100015

出　　处：《中国心理卫生杂志》2016年第12期891-895,共5页Chinese Mental Health Journal

基　　金：北京大学人民医院研究与发展基金(2118000672)

摘　　要：目的:研究急性白血病患者焦虑障碍的检出率和危险因素,为早期识别和干预白血病患者中焦虑障碍提供依据。方法:本研究设计为现况调查,选取2013年11月至2015年5月在某综合医院血液科确诊的白血病患者548人,首先应用广泛性焦虑量表(GAD-7)为筛查工具,简明国际神经精神访谈(M.I.N.I.)为诊断工具,分别评估该人群中焦虑症状和焦虑障碍的检出率。其次分析社会人口学资料及临床分型,了解共患焦虑障碍的危险因素。再次比较GAD-7和M.I.N.I.两种检查工具的一致性。结果:白血病患者焦虑症状的检出率(筛查阳性率)为19.2%(105/548),各类焦虑障碍检出率(诊断阳性率)为13.3%(73/548),其中女性(23.5%vs.16.1%)、非在职者(39.4%vs.15.0%)、分型为急性淋巴细胞白血病(ALL)者(23.7%vs.15.7%)中筛查阳性率高于男性、在职者和白血病分型为急性髓性白血病(AML)者。筛查阳性率高于诊断阳性率,二者一致性评价kappa值为0.43,P<0.001。结论:白血病患者各类焦虑症状的检出率为19.2%,应该注意性别、职业状态、白血病临床分型等风险因素。Objective： To study the prevalence and risk factors of anxiety disorder in acute leukemia patients and to provide reference for early recognition and special intervention for acute leukemia anxiety disorder patients. Methods： Totally 548 leukemia patients were selected from a general hospital hematology department since November 2013 to May 2015. The 7-tiem Generalized Anxiety Disorder Scale （GAD-7） and the Mini International Neuropsychiatric Interview （ M. I. N. I. ） were used to evaluating the rate of anxiety symptoms and detecting the rate of anxiety disorder. The social demographic data and clinical classification were analyzed to explore the risk factor for anxiety disorders. The consistency of GAD-7 and M. I. N. I. was compared. Results： The rate of leukemia pa- tients with anxiety symptoms （screening positive rate） was 19.2% （105/548）, the rate of anxiety disorders diagno- sis （diagnosing positive rate） was 13.3% （73/548）. The screening positive rates were higher in those being female （23.5% vs. 16. 1% ）, without employment （39. 4% vs. 15. 0 % ）, with acute lymphoblastic leukemia （ALL） （23.7% vs. 15.7 % ） than in those being male, in-service staff, and with acute myeloid leukemia （AML）. Although screening positive rate was higher than diagnosing positive rate, the consistency between results of GAD-7 andM. I. N. I. was moderate （with kappa = 0.43, P 〈 0. 001）. Conclusion： The rate of leukemia patients with anxiety symptoms is 19. 2%. The risk of anxiety disorder in acute leukemia patients may be associated with gender, occupa- tional status and leukemia clinical classification.

关 键 词：白血病 焦虑 广泛性焦虑量表 现况调查 

分 类 号：R749.72[医药卫生—神经病学与精神病学] R557[医药卫生—临床医学]