高血压与抑郁障碍和焦虑障碍共患率及关联因素现况研究  

Cross-sectional study of prevalence and association factors for hypertension comorbid depressive and anxiety disorders

作　　者：张宇姝 王丽敏[1] 黄悦勤[2] 张梅[1] 赵振平[1] 张笑[1] 李纯[1] 黄正京[1] 刘肇瑞[2] 张婷婷[2] 高星星 姜博 ZHANG Yushu;WANG Limin;HUANG Yueqin;ZHANG Mei;ZHAO Zhenping;ZHANG Xiao;LI Chun;HUANG Zhengjing;LIU Zhaorui;ZHANG Tingting;GAO Xingxing;JIANG Bo(Chronic Disease Risk Factor Surveillance Room,Chronic and Noncommunicable Disease Prevention and Control Center,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Peking University Sixth Hospita,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disor ders(Peking University Sixth Hospital),Beijing 100083,China)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室,北京100050 [2]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083

出　　处：《中国心理卫生杂志》2024年第12期1021-1027,共7页Chinese Mental Health Journal

基　　金：国家重点研发计划(2018YFC1311706)。

摘　　要：目的:描述高血压人群抑郁障碍和焦虑障碍的患病率,探讨关联因素。方法:利用2013年中国慢性病及其危险因素监测与2013-2015年中国精神卫生调查合并所得数据库,以其中的4861名高血压患者作为研究对象,以美国精神障碍诊断与统计手册第4版为抑郁障碍和焦虑障碍的诊断标准,计算抑郁障碍和焦虑障碍的12个月患病率,采用多因素logistic回归模型探讨高血压共患抑郁障碍和焦虑障碍的关联因素。结果:在4861名高血压患者中,抑郁障碍和焦虑障碍的12个月患病率分别为4.1%和5.0%。汉族[OR(95%CI):2.00(1.01~3.93)]、睡眠不足[OR(95%CI):1.82(1.34~2.48)]、过去1年患心肌梗死[OR(95%CI):2.35(1.18~4.67)]、过去1年患脑卒中[OR(95%CI):2.10(1.19~3.72)]以及慢阻肺患病[OR(95%CI):2.11(1.11~4.05)]是高血压共患抑郁障碍的危险因素。与本次测量中血压值高于正常范围的人群相比,血压得到控制[OR(95%CI):2.01(1.30~3.13)]的高血压人群共患抑郁障碍的风险更高。汉族[OR(95%CI):2.51(1.32~4.80)]、西南地区[OR(95%CI):1.64(1.02~2.63)]以及睡眠不足[OR(95%CI):1.45(1.09~1.93)]是高血压共患焦虑障碍的危险因素。以前吸烟但现在不吸[OR(95%CI):0.48(0.23~0.99)]是高血压共患焦虑障碍的保护因素。结论:该高血压人群中焦虑障碍的12个月患病率高于抑郁障碍。汉族和睡眠不足的高血压人群共患抑郁障碍和焦虑障碍的风险均更高。Objective:To study the prevalence and association factors of depressive and anxiety disorders in the hypertensive population.Methods:Using the database obtained from the 2013 China Chronic Disease and Risk Factor Surveillance and the 2013-2015 China Mental Health Survey,4861 hypertensive residents were used as study subjects.And using the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV)as diagnostic criterion for depressive and anxiety disorders,the 12-month prevalence was calculated.Multifactorial lo.gistic regression models were used to explore the association factors of hypertension comorbid depressive and anxie ty disorders.Results:The 12-month prevalence rates of depressive disorders and anxiety disorders were 4.1%and 5.0%in 4861 hypertensive residents.Chinese Han[OR(95%CI):2.00(1.01-3.93)],lack of sleep[OR(95%CI):1.82(1.34-2.48)],having myocardial infarction[OR(95%C1):2.35(1.18~4.67)]and stroke in the past year[OR(95%CI):2.10(1.19-3.72)],and chronic obstructive pulmonary disease[OR(95%CI):2.11(1.11-4.05)]were risk factors of hypertension comorbid depressive disorder.Hypertensive people with controlled blood pressure[OR(95%CI):2.01(1.30-3.13)]had a higher risk of co-morbid depressive disorder than those with blood pressure above the normal range on this measurement.Chinese Han[OR(95%C):2.51(1.32-4.80)].Southwest China[OR(95%CI):1.64(1.02-2.63)],and lack of sleep[OR(95%CI):1.45(1.09-1.93)]were risk factors of hypertension comorbid anxiety disorder.Former but current non-smoking[OR(95%CI):0.48(0.23-0.99)] was a protective factor of hypertension comorbid anxiety disorder.Conclusion:The 12-month prevalence of anxiety disorder was higher than that of depressive disorder in this hypertensive population.Both Han and sleep deprived hypertensive people had a higher risk of comorbid depressive and anxiety disorders.

关 键 词：高血压 抑郁 焦虑 共患病 关联因素 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]