精神专科医院门诊抑郁症患者就诊影响因素分析

目的 调查精神专科医院门诊抑郁症患者的就诊特点,探讨影响抑郁症患者及时就诊和选择首次就诊(首诊)医疗机构的因素.方法 选择北京市2所精神专科医院的156例抑郁症患者,采用自编调查表对患者的一般情况、患病及就诊情况进行调查.结果 (1)及时就诊组(发病≤3个月到精神科就诊,61例)与非及时就诊组(发病＞3个月到精神科就诊,95例)在对疾病性质的认识、第一主诉、病耻感、首诊医疗机构、就诊途径、花费的医疗费用及抑郁症阳性家族史等的差异有统计学意义(经x<'2>检验,P＜0.05或P＜0.01);(2)精神专科组(首诊医疗机构选择精神专科,52例)与非精神专科组(首诊医疗机构选择非精神专科,104例)在对疾病性质的认识、第一主诉、抑郁症阳性家族史、花费的医疗费用、婚姻状况、受教育程度等的差异有统计学意义(经X<'2>检验,P＜0.05或P＜0.01);(3)以患者首诊医疗机构作为因变量,将以上项目作为自变量进行Logistic回归,第一主诉、疾病性质的认识进入回归方程,各变量比值比分别为6.379和2.714.结论 (1)对疾病性质的认识、第一主诉、病耻感、就诊途径、首诊医疗机构的选择、受教育程度、抑郁症阳性家族史等因素,对抑郁症患者能否及时就诊有较大影响;(2)对疾病性质的认识、第一主诉、抑郁症阳性家族史、受教育程度、婚姻状况等因素可影响抑郁症患者对首诊医疗机构的选择.

Related factors to outpatient service visit of patients with depression in psychiatric hospitals

Objective To investigate the related factors to outpatient service visit of patients with depression in psychiatric hospitals and to analyze the factors related to their timely-visit and choice of medical service at initial visit.Methods One hundred and fifty-six depressive outpatients (including initial visit and return visits) in Peking University Sixth Hospital and Beijing Huilongguan Hospital during May 2007 to October 2007 were investigated.The investigation was carried out by using a self-designed questionnaire, which included general conditions of patients,course of disease and counseling information,et al.Chi-square test and Logistic regression analysis were used to analyze the relationship among several factors with clinical characteristics.Results (1) There was statistical difference between timely-visit group ( visiting a psychiatrist in less than 3 months after onset) and delay-visit group ( visiting a psychiatrist in more than 3 months after onset) in insight of the disease,chief complaints,stigma about disease,medical service of first counseling,pattern of visit,cost of visit and positive family history ( P ＜ 0.05 or P ＜0.01 ).(2) There was statistical difference between psychiatric hospital visit group (first visit in a psychiatric hospital) and non-psychiatric hospital visit group (first visit in a non-psychiatric hospital) in their insight of the disease,chief complaints,positive family history,cost of visit,marriage status and education level (P ＜0.05 or P ＜ 0.01 ).(3) Logistic regression analysis showed that the chief complains and insight of the disease was related to the patients' hospital choice at the first visit (odds ratio of 6.379 and 2.714).Conclusions The related factors to the timely visit of outpatients with depression are their insight of the disease,chief compliance,stigma of disease,pattern of visit,choice of hospital service at their first visit,education level and positive family history,and the insight of the disease,chief complaints,positive family history, education level and marriage status are related to the outpatients' choice of medical service at their first visit.