综合医院门诊肠易激综合征病人抑郁/焦虑影响因素研究

目的 探讨中国大城市消化内科肠易激综合征门诊患者抑郁/焦虑症状可能影响因素.方法 采用现况研究方法,于2004年6月1日到9月1日在北京、广州和成都的6家综合性医院的消化内科门诊连续收集肠易激综合征303例.由经培训的调查员采用统一的调查表进行面对面调查,同时使用综合医院焦虑抑郁量表(HAD)进行心理测评.对数据进行多元无序多分类Logistic回归分析.结果 IBS患者自评的目前健康状况与医疗保险与抑郁、焦虑或两者合并发生均有统计学关联,目前健康状况差的患者相应OR值分别是2.366(95%CI:1.041～5.375)、5.446(95%CI:1.036～28.622)和4.736(95%CI:2.046～10.946);没有医疗保险的患者相应OR值分别是2.705(95%CI:1. 140～6.422)、4.886(95%CI:1.102～21.664)和3.264(95%CI:1.296～8.224);而负性生活事件的发生使得患者更容易发生单纯抑郁(OR=3.680,95%CI:1.491～9.081).结论 自评目前健康状况差和无医疗保险是中国大城市综合医院IBS门诊患者罹患抑郁和/或焦虑症状的可能危险因素,而近期有负性生活事件发生是罹患单纯抑郁症状的可能危险因素,这些病人的抑郁焦虑问题应该在临床诊疗过程中得到更多关注.

A Cross-sectional Study on Risk Factors of Depressive and/or Anxiety Symptoms in Outpatients with Irritable Bowel Syndrome of Urban China

Objective To explore possible risk factors of depressive and/or anxiety symptoms in outpatients with Irritable Bowel Syndrome (IBS) in the general hospital of main China cities. Methods This was a hospital-based cross-sectional study conducted in three main cities in China in 2004. 303 eligible subjects with IBS were recruited from the outpatient departments continually within three months. Face-to-face interview was used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptoms screening. Multinomial Logistic Model was adopted in data analysis. Results Among 303 IBS patients, 75(24.8%) obtained a HAD score of 9 and above. Subjects with a self-assessment of poor health status (OR=2.366, 95%CI: 1.041~5.375; OR=5.446, 95%CI: 1.036~28.622; OR=4.736, 95%CI: 2.046~10.946) and without medical insures (OR=2.705, 95%CI: 1.140~6.422; OR=4.886, 95%CI: 1.102~21.664; OR=3.264, 95%CI: 1.296~8.224) were more liable to suffer depressive symptoms, anxiety symptoms and both symptoms and those with negative events within recent 2 months before this survey had higher risk of depressive symptoms (OR=3.680, 95%CI: 1.491~9.081). Conclusion It was noticeable to health care providers both in somatic disease care and mental health care that poor health, no medical insures and negative events were possible risk factors for depressive and/or anxiety symptoms in outpatients with IBS in general hospitals in urban China.