心内科门诊患者焦虑抑郁情况调查

1．1对象 2006年2月至4月连续调查北京军区总医院心内科门诊患者380（男209,女171）例,调查一般情况、就诊主诉及焦虑、抑郁合并情况。患者年龄13～86岁,平均（44．6±13．2）岁。     

功能性排便障碍患者合并焦虑、抑郁和躯体症状的调查

目的了解功能性排便障碍患者合并焦虑、抑郁及躯体症状阳性率及其危险因素分析。 方法选择2020年11月~2021年9月期间就诊于西京消化病院便秘专科门诊的功能性排便障碍患者86例,根据GAD-7、PHQ-9和PHQ-15量表计分,统计患者合并焦虑、抑郁及躯体症状的发生率,并采用Logistics回归分析其危险因素。 结果入组患者86例,男性18例（20.9%）,女性68例（79.1%）,平均年龄（46.7±13.4）岁,中位病程7.5（3~15.3）年。焦虑的发生率80.2%,抑郁的发生率73.2%,躯体症状的发生率94.2%。单因素回归分析可见排便费力（χ²=10.489,P＜0.05）和排便不尽感（χ²=9.389,P＜0.05）与患者合并躯体症状相关。多因素回归分析显示排便不尽感是患者合并焦虑（OR=4.831,95%CI：1.364~17.117,P＜0.05）、抑郁（OR=4.214,95%CI：1.162~15.282,P＜0.05）和躯体症状（OR=7.809,95%CI：1.058~57.617,P＜0.05）的独立危险因素。 结论功能性排便障碍患者极易伴发焦虑、抑郁及躯体症状且患者具有排便不尽症状是合并焦虑、抑郁及躯体症状的独立危险因素。     

心血管疾病与焦虑抑郁障碍

焦虑、抑郁障碍具有高发病、高复发、高致残、症状重、慢性化、需要更多的医疗服务等特点,是医疗资源的沉重负担。由于焦虑抑郁障碍患者常因各种情绪相关性躯体症状,反复求诊于各临床科室,而成为基层医疗资源的高频率使用者。研究发现焦虑障碍所花的医疗费用大约是一般人口的9倍。据调查,在医疗资源利用率高的人群中,40%为抑郁障碍患者,21.8%为广泛性焦虑障碍患者,12%为惊恐障碍患者。据世界卫生组织预测到     

心血管疾病患者焦虑抑郁症状调查研究

目的了解心血管疾病患者焦虑抑郁症状发病情况和临床特征并分析其影响因素,为临床治疗提供依据。方法纳入2012年1月～2012年3月1105例心血管疾病患者,所有患者均接受综合医院焦虑抑郁量表、汉密尔顿抑郁量表和汉密尔顿焦虑量表进行心理状况检测,评估焦虑、抑郁的发生率,采用Logistic回归分析对相关危险因素进行评价,观察在使用心血管药物治疗联合心理干预的治疗效果。结果所纳入心血管疾病患者中焦虑和抑郁患者占22.81%（252/1105）,其中53.97%（136/252）为焦虑,31.35%（79/252）为抑郁,14.68%（37/252）同时合并焦虑和抑郁。多因素非条件Logistic回归分析显示：健康状况、工作状态和工作劳累程度是焦虑抑郁的主要危险因素（P＜0.05）。在使用心血管药物治疗的基础上合并使用抗焦虑抑郁药物同时配合心理干预治疗后总有效率达95.63%。结论心血管疾病住院患者中焦虑抑郁症状发病率较高,焦虑抑郁症状受到多种因素影响,在治疗心血管疾病的基础上进行抗焦虑抑郁治疗有助于改善患者整体状况。     

躯体疾病对老年抑郁症状转归的影响

目的探讨老年人躯体疾病对抑郁症状转归的影响,为防治老年人抑郁,改善抑郁症状提供依据。方法采用按类分层、随机、整群等距的抽样原则,在北京城乡社区老年人群中抽取有效样本2 506例,分别于2000和2004年采用综合问卷进行入户调查。结果 2000年共检出抑郁症状者282例,在2004的调查中,对这282名老年人进行了追踪调查,将其转归分为:好转、无变化、加重和死亡。其中<75岁老人抑郁症状的好转率高于≥75岁老人;<75岁老人抑郁症状的加重率及死亡率均低于≥75岁老人。除青光眼以外,其他各类慢性病患者的抑郁症状好转率均低于无此疾病的对照人群,其中无骨关节病和听力障碍的老年人抑郁症状的好转率明显高于有骨关节病和听力障碍的老年人(P<0.05)。结论为了降低老年抑郁症状的发病风险和改善老年抑郁症状的预后,提高老年人的生活质量,应该重视老年人躯体功能的改善。     

沙库巴曲缬沙坦对慢性心力衰竭患者躯体化症状及焦虑抑郁的影响

目的 探讨沙库巴曲缬沙坦对慢性心力衰竭患者躯体化症状及焦虑抑郁的影响。方法 选取2019年1月1日至2021年1月31日于黄山首康医院住院治疗的142例慢性心力衰竭患者,按治疗方式不同分为治疗组（74例）和对照组（68例）。治疗组采用血管紧张素受体-脑啡肽酶抑制剂（ARNI）沙库巴曲缬沙坦治疗,对照组采用其他ACEI/ARB治疗。两组患者入院时及3个月随访均行心功能状态评价、采用躯体化症状自评量表（SSS）、广泛性焦虑障碍量表（GAD-7）及病人健康问卷抑郁自评量（PHQ-9）对患者进行躯体化症状、焦虑抑郁状态评价。结果 治疗组的治疗总有效率为91.9%,高于对照组的73.5%,差异有统计学意义（P<0.05）;治疗前两组患者的左室射血分数（LVEF）比较,无统计学差异（P>0.05）。治疗后,两组患者的LVEF比较,差异有统计学意义（P<0.05）;治疗组躯体化症状评分较对照组下降更明显,具有显著差异（P<0.01）;治疗后两组患者抑郁和焦虑状态均有所改善,治疗组改善程度更为明显,差异有统计学意义（P<0.05）;治疗组的6分钟步行试验（6-MWT）较对...     

心血管疾病与焦虑心理的躯体化表现

加拿大的Ｆｌｅｅｔ等综合了6个研究报告的结果后提出,心血管疾病患者如合并焦虑与惊恐发作,必将影响患者的生活质量,并将明显增加心血管并发症和心源性猝死;治疗则需抗焦虑与心血管病同治,才能取得较满意的效果[1]。1　发生率(ＩｎｃｉｄｅｎｔａｌＲａｔｅ)1.1　据以色列的Ｆｒａｅｎｋｅｌ等报道:将由于胸痛进行冠脉造影的患者152例分成3组,第一组:冠心病,冠脉造影阳性患者66例;第二组:冠心病,冠脉造影阴性患者20例;第三组:非冠心病患者66例。结果:第一组患者合并惊恐障碍(ＰａｎｉｃＤｉｓｏｒｄｅｒ;ＰＤ)12例;第二组合并ＰＤ患者9例(4…     

心脏移植受者术后社会支持与焦虑抑郁状况、躯体功能相关性分析

目的：探讨心脏移植受者术后社会支持与焦虑抑郁状况、躯体功能相关性。方法：选取2014年12月-2015年12月于我院心脏移植外科接受同种心脏移植且手术顺利出院的受者192例作为研究对象。采用自制《心脏移植受者居家康复状况问卷》收集受者的一般资料，采用《心脏移植受者躯体功能评估表》评估其躯体功能，采用《焦虑抑郁量表（HAD）》评估其心理功能；采用《社会支持评定量表（SSRS）》评估社会支持能力，然后采用单因素和多因素Logistic回归分析心脏移植受者康复影响因素；采用Spearman分析社会支持和焦虑抑郁状况、躯体功能相关性。结果：心脏移植受者躯体功能评分为（15.30±4.31）分，各项得分来看，躯体功能有好到差分别为：自我照顾、活动功能、心肺功能、睡眠以及疲劳状况；焦虑得分为（6.24±2.16）分，其中120例（62.50%）无症状，8例（4.17%）症状可疑，64例（33.33%）存在症状；抑郁得分为（6.39±1.72）分，其中112例（58.33%）无症状，48例（25.00%）症状可疑，32例（16.67%）存在症状；社会支持总分、客观支持、主观支持以及社会支持利用度得分分别为（33.01±5.89）分、（8.62±2.79）分、（17.59±3.91）分和（6.79±1.71）分。单因素结果显示影响心脏移植受者躯体功能的危险因素有文化程度、月药费支出以及是否重返工作；影响心脏移植受者心理功能的危险因素有文化程度、职业、月药费支出、医疗支付方式；影响社会支持的危险因素为是否重返工作。Logistic回归分析结果显示影响躯体功能的因素是文化程度和是否重返工作岗位，影响心理功能的因素是职业和文化程度，影响社会支持的因素是是否重返工作岗位。Spearman相关性分析结果显示，社会支持总分与躯体功能评分呈明显的正相关关系，而与焦虑和抑郁评分呈明显的负相关关系（P＜0.05）。结论：给予心脏移植受者足够的社会支持有利于心脏移植受者躯体和心理功能恢复，且应鼓励其重返工作岗位，提高社会适应能力。     

老年住院患者抑郁症状及其与躯体疾病关系的临床分析

因躯体疾病住院的老年患者中合并抑郁症状的并不少见 ,但一般综合医院对此重视不够 ,容易漏诊 ,从而影响治疗 ,甚至发生不良后果。为此 ,我们对因各种躯体疾病住院的老年患者进行抑郁症状的筛查 ,并分析讨论如下。　　一、对象及方法　　 1.对象 :1998年因各种躯体疾病住综合科病例资料完整的 13 8例老年患者 ,其中男性 115例 ,女性 2 3例。年龄 60～ 89岁 ,平均 ( 73 8± 6 6)岁。　　 2 .方法 :发放调查问卷和老年抑郁量表 (ＧＤＳ) ,在医护人员指导下由患者自己填写。调查问卷包括一些自然特征、生活习惯等方面的内容。采用 1982年由Ｂ…     

绝经综合征患者焦虑、抑郁与血管收缩症状的相关性

<正>绝经早期主要表现为血管舒缩综合征,绝经综合征患者的焦虑、抑郁与病情呈正相关,且病情越重越容易出现焦虑、抑郁,考虑可能原因是病情严重患者因躯体、血管收缩症状经治疗后未好转等导致〔1〕。本文研究焦虑、抑郁与绝经期生存质量(MENQOL)量表中血管收缩症状的关系。1资料与方法1.1病例资料2001~2006年北京、广州、上海、成都、天津、湖北地区经确诊为女性更年期综合征患者1 546例,年龄41~     

抑郁的躯体化与冠心病发生的关系

目的探讨抑郁的躯体化与冠状动脉(冠脉)粥样硬化性心脏病(冠心病)的关系。方法根据冠脉造影Gensini评分将349例冠心病患者分为<30分组和≥30分组,两组均采用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)进行评估。结果与冠脉病变Gensini评分<30分组比较,≥30分组年龄更大、吸烟者更多、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)浓度更低及HAMD评分更高(P<0.05);回归分析显示焦虑/躯体化(OR=1.99,95%CI:1.71~2.31,P<0.001)是冠心病发病的高危因素。结论抑郁症状越重,冠脉病变越严重,抑郁的躯体化是冠心病发病的高危因素。     

Zung焦虑抑郁自评量表对消化内科门诊患者焦虑抑郁的测评

[目的]探讨综合医院消化内科门诊患者焦虑抑郁障碍的发病情况及其影响因素。[方法]随机入选547例消化内科就诊的患者,采用Zung氏焦虑自评量表(SAS)与抑郁自评量表(SDS)对其进行测评。[结果]在547例受试者中,SAS得分高于正常值152例(占27.8%),其中112例(20.5%)为轻度焦虑,33例(6.0%)为中度焦虑,7例(1.3%)为重度焦虑;SDS得分高于正常值158例(占28.9%),其中113例(20.7%)为轻度抑郁,38例(7.0%)为中度抑郁,7(1.3%)例为重度抑郁。焦虑抑郁障碍患者性别、婚姻情况及教育程度间的比较差异有统计学意义(P0.05~0.01)。女性、离异或丧偶者、高学历人群处于高焦虑抑郁状态。[结论]在综合医院消化内科门诊患者中焦虑抑郁障碍的发生率较高,尤其是女性、离异或丧偶者、高学历人群是影响焦虑与抑郁的重要因素。     

Prevalence of symptoms of depression and anxiety in a diabetes clinic population.

AIMS: To investigate the use of a short questionnaire to measure psychological symptoms in a busy clinic setting, and to examine the prevalence of these symptoms in adults with diabetes. The perceived need for psychological treatment services was also measured. METHODS: Adults (> 18 years) with either Type 1 or Type 2 diabetes were invited to complete a short demographic form and the Hospital Anxiety and Depression Scale (HADS) whilst waiting for their routine diabetes outpatients appointment. Complication status was measured via patients' medical records. Glycaemic control (HbA(1c)) was also recorded. RESULTS: A high response rate (96%) was achieved. Prevalence rates of psychological symptoms were high (overall 28% of study participants reported moderate-severe levels of depression or anxiety or both). Men were somewhat more likely to report moderate-severe depressive symptoms, whereas women reported more moderate-severe anxiety. A significant association between depression and poor glycaemic control was observed in the men, but not in the women. Regression analysis demonstrated that the interaction between sex and glycaemic control, HbA(1c) and sex were all significantly associated with depression and anxiety (R2 = 0.16 and 0.19, respectively). One-third of subjects reported that at the moment they would be interested in receiving counselling or psychotherapy if it was currently available at the diabetes clinic. CONCLUSIONS: This study has shown that the HADS is an appropriate questionnaire to use in a clinic setting in adults with diabetes. There may be a stronger association between glycaemic control and psychological symptomatology in men than in women. There remains a significant proportion of individuals with diabetes who require psychological support, which, if available, might help improve glycaemic control and thus overall wellbeing.     

Somatic symptoms and the association between hepatitis C infection and depression in HIV-infected patients

Studies of depression and hepatitis C virus (HCV) infection in HIV-infected patients have been contradictory and often not addressed key differences between HCV-infected and uninfected individuals including substance use. This cross-sectional observational study from the University of Washington HIV cohort examined associations between HCV, symptoms, and depression in HIV-infected patients in routine clinical care. Patients completed instruments measuring depression, symptoms, and substance use. We generated depression severity scores and used linear regression to examine the relationship with HCV accounting for demographic and clinical characteristics. We conducted sensitivity analyses in which we removed depression somatic symptom items (e.g., fatigue) from depression scores, and sensitivity analyses in which we also adjusted for nondepression somatic symptom items to examine the role of somatic and nonsomatic symptoms in the association between depression and HCV. Of 764 HIV-infected patients, 160 (21%) were HCV-infected. In adjusted analysis, HCV-infected patients had worse depression severity (p =0.01) even after adjusting for differences in substance use. HCV remained associated with depression severity in secondary analyses that omitted the depression somatic patient health questionnaire-9 (PHQ-9) items (p=0.01). However, when nondepression somatic symptoms were included as covariates in multivariate analyses, HCV was no longer associated with depression (p=0.09).     

老年男性体检人群焦虑和抑郁调查分析

目的探讨老年男性体检人群焦虑和抑郁的患病水平及主要影响因素,为早期开展针对性防控提供依据。方法采用医院焦虑抑郁量表(HADS),对解放军总医院2015年3月至2015年7月1132例接受常规健康体检的老年男性进行横断面调查,年龄(75.2±9.5)岁,其中60~69岁364例,70~79岁363例,≥80岁405例。结果老年男性体检人群焦虑和抑郁问题相对较轻,焦虑阳性率为2.5%,抑郁阳性率为4.3%。其中≥80岁高龄老年人的焦虑和抑郁阳性率分别为2.5%和6.4%。饮食偏好和睡眠障碍是影响老年男性人群焦虑和抑郁的危险因素。饮食偏好对焦虑和抑郁阳性率影响的OR值分别为2.10(95%CI:1.03~4.26,P=0.041)和1.84(95%CI:1.07~3.18,P=0.028)。睡眠障碍对焦虑和抑郁情绪阳性率影响的OR值分别为1.81(95%CI:1.10~2.97,P=0.002)和2.77(95%CI:1.47~5.23,P=0.020)。饮酒是老年男性人群抑郁的保护因素,其OR值为0.47(95%CI:0.27~0.84,P=0.010),即相对于现在不饮酒者(包括既往饮酒和从不饮酒),现在饮酒者发生抑郁的风险下降53%。结论老年男性体检人群焦虑和抑郁问题相对较轻。饮食偏好、现在饮酒和睡眠障碍是影响因素。这也提示我们要重视老年人群的焦虑和抑郁问题,并早期开展针对性干预措施,以减少严重心理问题的发生。     

氟哌噻吨美利曲辛片对慢性阻塞性肺疾病合并焦虑抑郁症状患者的临床影响

目的研究黛力新(氟哌噻吨美利曲辛片)对慢性阻塞性肺疾病(COPD)合并抑郁焦虑症状患者的临床影响。方法选取2018年1月至2019年1月在解放军96605部队医院呼吸内科住院治疗的COPD合并焦虑和(或)抑郁患者共128例为研究对象。分为2组:黛力新组和对照组,每组64例。对照组患者给予COPD规范化治疗;黛力新组在对照组基础上每天清晨口服黛力新。治疗4周后,对比2组患者治疗前后汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、临床症状和改良版英国医学研究会呼吸困难量表(mMRC)评分,以及1 s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1占预计值百分比(FEV1%pred)和FEV1/FVC等肺功能检查指标。采用SPSS 19.0软件进行数据处理。依据数据类型,组间比较分别采用t检验或χ~2检验。结果 128例患者焦虑合并抑郁47例,单独焦虑57例,单独抑郁24例。治疗后黛力新组患者的HAMA[(6.1±1.3)vs(10.7±1.9)]、HAMD[(7.6±1.7)vs(9.7±2.0)]、症状[(3.2±1.3)vs(6.0±1.7)]和mMRC[(1.1±0.7)vs(1.9±0.4)]评分均显著低于对照组,而FEV1/FVC[(78.3±3.9)%vs(67.9±4.4)%]显著高于对照组,差异均具有统计学意义(P0.05)。结论黛力新能有效缓解COPD患者焦虑抑郁症状和改善患者的生活质量。     

Anxiety,depression, and HIV symptoms among persons living with HIV/AIDS: the role of hazardous drinking

Hazardous drinking is common among persons living with HIV/AIDS (PLWHA) and associated with numerous negative health consequences. Despite the well-established negative effects of hazardous drinking among PLWHA, scholarly work has neglected to explore the role of such drinking in regard to anxiety/depressive symptoms and HIV symptom expression. The current study investigated associations between hazardous drinking and anxiety/depressive symptoms and HIV symptoms among PLWHA. Participants (n = 94; 88.3% male; M_age = 48.55; SD = 9.15) included PLWHA recruited from AIDS service organizations in the northeast. Hazardous drinking was significantly associated with anxiety/depressive symptoms and HIV symptom expression above and beyond the variance accounted for by sex, race, recruitment site, and CD4 T-Cell count, as well as other cognitive-affective variables (emotion dysregulation, distress intolerance, and anxiety sensitivity). The present results provide empirical support that hazardous drinking is indeed related to depressive and anxiety symptoms as well as HIV symptom distress and that this effect is not attributable to other factors commonly related to both alcohol use problems and emotional distress among PLWHA. Results highlight the importance of alcohol interventions for excessive drinking specifically tailored for PLWHA to facilitate better mental and physical health adjustment.     

The relationship between fibromyalgia and depression,anxiety, anxiety sensitivity,fear avoidance beliefs,and quality of life in female patients

The study aims to determine whether there is a relationship between fibromyalgia (FM) disease and depression, anxiety, anxiety sensitivity, fear-avoidance beliefs, and quality of life in female patients with a diagnosis of fibromyalgia. 37 female patients followed up with FM diagnosis in pain medicine clinic and a control group consisting of 37 healthy women were included in the study. Sociodemographic and Clinical Characteristics Data Form, Quality of Life Form, fear-avoidance beliefs questionnaire, Anxiety Sensitivity Index-3, Beck Anxiety Inventory, Beck Depression Inventory, and Visual Analogue Scale was applied to the participants. When the patients in the FM group were compared to the control group; Statistically lower scores in all Quality of Life Form subscales except emotional role difficulty and social functionality scores; statistically higher scores in both physical and work activity subscales in fear-avoidance beliefs questionnaire; statistically higher scores in cognitive symptoms subscale in Anxiety Sensitivity Index-3, Beck Anxiety Inventory, Beck Depression Inventory, and Visual Analogue Scale scores were found. In FM patients, it has been determined that anxiety, depression and perceived pain severity reduce social functionality and quality of life in areas such as mental health, physical function, and emotional role difficulties. It was determined that the functionality and quality of life of patients diagnosed with FM decreased in daily life. An important contribution of the study to the literature is that it shows that the behavior of avoiding activity due to pain-induced fear exacerbates the pain and even contributes to its chronicity. These results, which show the effects of anxiety, depression, anxiety sensitivity, and fear-avoidance behavior on the prognosis of the disease in FM patients, indicate that psychiatric evaluation and treatment in FM patients is an important factor that determines the functionality and quality of life.