北京市综合医院门诊成年患者多躯体症状检出率及症状特点分析  

Detection rate and characteristics of adult outpatients with multiple somatic symptoms of general hospital in Beijing

作　　者：杨祥云 李占江 王鹏翀[1,2] 谭玲 李晓琪 胡永东[3] 韩学青 贺建华[5] 高见[1,2] 曹瑞想[1,2] 张艺 祖思[3] 崔飞环 崔少娟 Sun Jing[6] Yang Xiangyun;Li Zhanjiang;Wang Pengchong;Tan Ling;Li Xiaoqi;Hu Yongdong;Han Xueqing;He Jianhua;Gao Jian;Cao Ruixiang;Zhang Yi;Zu Si;Cui Feihuan;Cui Shaojuan;Sun Jing(The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China;Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Psychology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;School of Medicine,Griffith University,Gold Coast Q4222,Australia)

机构地区：[1]首都医科大学附属北京安定医院,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室,100088 [2]人脑保护高精尖创新中心首都医科大学,北京100069 [3]首都医科大学附属北京朝阳医院,100020 [4]首都医科大学附属北京同仁医院心理科,100730 [5]首都医科大学附属北京安贞医院,100029 [6]澳大利亚格里菲斯大学医学院,黄金海岸Q4222

出　　处：《中华精神科杂志》2019年第4期253-260,共8页Chinese Journal of Psychiatry

基　　金：首都卫生发展科研专项(首发2016-1-2121);北京市医院管理中心临床医学发展专项"扬帆"计划(ZYLX201815);北京市医院管理中心"青苗"计划专项(QML20181903).

摘　　要：目的了解及分析多躯体症状在神经内科、心内科、消化内科的检出率和临床特点。方法对就诊于北京朝阳医院、北京安贞医院、北京同仁医院神经内科、心内科、消化内科门诊的患者进行连续询问和筛查,收集入组的1 497例患者的一般人口学资料及疾病相关信息,应用患者健康问卷-15(PHQ-15)躯体症状群量表、患者健康问卷-9(PHQ-9)抑郁症状群量表评估患者的躯体症状及抑郁情绪;以PHQ-15评分10分作为划界分,将入组患者分为多躯体症状组(PHQ-15≥10分)和非多躯体症状组(PHQ-15<10分),计算多躯体症状的检出率,比较2组患者的人口学资料及疾病特征;应用偏相关分析病程、累计就诊次数、PHQ-9总分与PHQ-15总分的相关性。结果3家医院多躯体症状总体检出率为32.67%(489/1 497),消化内科检出率最高(37.74%,191/506)。多躯体症状组和非多躯体症状组在性别(χ^2=36.85,P<0.01),职业(χ^2=19.78,P<0.01),就诊科室(χ^2=9.64, P<0.01),初/复诊(χ^2=6.67,P<0.01),PHQ-9总分(χ^2=231.52,P<0.01)方面比较差异有统计学意义,其中女性检出率高于男性,退休和无固定职业的患者的检出率均高于有固定职业者,复诊患者检出率高于初诊患者。病程(r=0.07,P<0.05,Bonferroni校正)和PHQ-9总分(r=0.66,P<0.05,Bonferroni校正)与躯体症状严重程度呈正相关。结论3家综合医院多躯体症状检出率较高,其中消化内科最高;女性、退休、无职业、复诊、有抑郁情绪的患者多躯体症状检出率相对较高。抑郁情绪、病程与躯体症状严重程度呈正相关。Objective To explore the detection rate and clinical characteristics of multiple somatic symptoms among adult outpatients in cardiology,neurology and GI clinics.Methods The general demographic data and disease-related information of 1 497 patients in Beijing Chaoyang Hospital,Beijing Anzhen Hospital and Beijing Tongren Hospital were collected through continuous inquiry and screening.Physical symptoms and depressive symptoms were assessed by Patient Health Questionnaire-15 (PHQ-15) and Patient Health Questionnaire-9 (PHQ-9).The patients were divided into multiple somatic symptoms group (SOM+group,PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group,PHQ-15<10).The detection rate of multiple somatic symptoms was calculated.Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic,course of disease,cumulative number of visits,and the total score of PHQ-9.Results The overall detection rate of multiple somatic symptoms was 32.67%(489/1 497) in the three hospitals,and the highest was found in the department of digestive medicine (37.74%,191/506).There were significant differences in gender (χ^2=36.85,P<0.01),working status (χ^2=19.78,P<0.01),visiting department (χ^2=9.64,P<0.01),first visiting/repeated visiting (χ^2=6.67,P<0.01),and the total score of PHQ-9 (χ^2=231.52,P<0.01).The detection rate of female patients was higher than that of male patients.The detection rates of retired patients and patients who had no daily stable work were higher than patients who had daily stable work.The detection rate of re-visited patients was higher than that of first-visited patients.The illness duration (r=0.07,P<0.05,Bonferroni correction) and the total score of PHQ-9 (r=0.66,P<0.05,Bonferroni correction) were positively correlated with the severity of somatic symptoms measured by PHQ-15.Conclusions The detection rate of multiple somatic symptoms was high in general hospitals,especially highest in digestive outpatient clinics,and significantly higher in female,retired,unemployed

关 键 词：躯体型障碍 问卷调查 门诊患者 医院 综合 

分 类 号：R749.2[医药卫生—神经病学与精神病学]