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Prevalence of Depressive and Anxiety Disorders in the Peking Union Medical College Hospital and Current Clinical Practice
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摘要:
目的 了解综合医院神经科、消化科、心内科及妇科门诊中抑郁和/或焦虑障碍的患病情况、诊治现状和患者的治疗意愿。 方法 采用现况调查的方法, 对在北京协和医院神经科、消化内科、心内科及妇科门诊就诊的621例患者进行调查, 对医院焦虑抑郁量表评分≥ 8分者进行国际神经精神科简式访谈确定诊断, 并调查患者的治疗意愿。 结果 经过校正, 抑郁和/或焦虑障碍发生率神经科为33.4%、消化内科为18.8%、心内科为12.4%、妇科为25.5%, 总发生率约为22.5%, 门诊医生的识别率为18.9%。被调查者多愿意服用药物, 其次选择心理咨询, 再次选择精神科就诊。 结论 综合医院门诊患者具有较高的抑郁和/或焦虑障碍发生率, 门诊医生的诊断和治疗率不高, 不能满足患者的治疗需求。 Abstract:Objective To explore the prevalence of depressive and/or anxiety disorders in outpatients in neurology, gastroenterology, cardiology, and gynecology department from a general hospital. Methods A hospital-based cross-sectional study was conducted in the Peking Union Medical College Hospital in 2007.Totally 621 outpatients were recruited within one month.All of the subjects completed the self rated Hospital Anxiety and Depression(HAD)scale for screening, and patients with HAD scores ≥ 8 were further interviewed by psychiatrists.Psychiatric diagnoses were made using the Mini International Neuropsychiatric Interview(MINI). Results A total of 353 outpatients(56.8%)had ≥ 8 during screening, of them 281 were further interviewed by psychiatrists and 111 subjects were diagnosed as with depressive and/or anxiety disorders.Theses patients had more trouble in living, working, and social activities.The adjusted prevalence of depressive and/or anxiety disorders in outpatients in neurology, gastroenterology, cardiology, and gynecology were 33.4%, 18.8%, 12.4%, and 25.5% respectively.Only 18.9% of those patients were recognized during their outpatient visits.Among these interviewes, the preferred treatment mode was pharmacotherapy, followed by psychotherapy and referral to psychiatry. Conclusions The prevalence of depressive and/or anxiety disorders is high among outpatients in a general hospital.However, their treatment needs usually are not met due to low percentages of diagnosis and treatment. -
Key words:
- depressive disorder /
- anxiety disorder /
- cross-sectional study /
- general hospital
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表 1 各科门诊调查例数及年龄、性别分布
科室 人数 男/女 年龄(岁) 神经科 157 72/ 84 48. 9±15. 1 (18~ 79) 神经科 157 72/ 84 48. 9±15. 1 (18~ 79) 消化内科 156 60/ 95 50. 3±14. 0 (18~ 85) 心内科 151 72/ 79 60. 3±14. 2 (19~ 86) 妇科 157 0/157 35. 9±9. 6 (21~ 67) 总计 621 204/415 48. 7±15. 9 (18~ 86) 
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表 2 各科门诊抑郁或焦虑障碍至少符合一项者
科室 抑郁或焦虑障碍 无抑郁和
焦虑障碍χ2 P值 n % 神经科 41 26. 1 116 13. 113 0.004 消化内科 25 16. 0 131 心内科 16 10. 6 135 妇科 29 18.5 128
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表 3 各科医生与精神科医生对抑郁障碍或焦虑障碍的识别
精神科访谈诊断 药物治疗或转诊精神科 神经科 消化内科 心内科 妇科 符合抑郁或焦虑障碍至少一项 48. 78%(20/ 41) 0. 00% (0/ 25) 0. 00% (0/ 16) 3. 45% (1/ 29) 无抑郁及焦虑障碍 13. 79% (16/116) 0. 76% (1/131) 3. 70% (5/135) 3. 91% (5/128)
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表 4 各科门诊就诊者对抑郁/焦虑障碍的治疗意愿
治疗意愿 神经科(n=80) 消化内科(n=75) 心内科(n=53) 妇科(n=73) n % n % n % n % 愿意心理咨询 51 63. 8 32 42.7 26 49.1 41 56.2 愿意看精神科 33 41.3 14 18.7 22 41.5 17 23.3 愿意药物治疗 57 71.3 38 50.7 33 62.3 32 44.4
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