非精神科医生对抑郁障碍的识别和相关因素

目的 了解非精神科医生对抑郁障碍的识别及相关因素.方法 对北京三所三级医院连续就诊患者进行横断面调查,抑郁障碍患者经国际神经精神科简式访谈问卷进行诊断,非精神科医生对抑郁障碍的"识别"定义为给予抑郁障碍患者精神类药物或建议精神科就诊.结果 非精神科医牛对抑郁障碍的识别率为21.0%,其中神经科医生的识别率为40.4%,明显高于心内科(22.4%)、消化科(3.8%)和妇科(2.0%)(x2=61.077,P<0.05).就诊于神经科、疾病对生活的影响大、有精神障碍病史、主诉精神心理主题、合并焦虑障碍是非精神科医生识别抑郁障碍的相关因素(P<0.05);精神心理主题主诉中,情绪问题和失眠问题与非精神科医牛对抑郁障碍识别的联系有统计学意义(P<0.05).结论 综合医院非精神科医牛对抑郁障碍的识别率较低;疾病对生活的影响大,有精神障碍的病史,主诉情绪和失眠问题的抑郁障碍患者更容易被医生识别.

Recognition of depression and related risk factors among non psychiatric doctors in tertiary general hospital outpatients in Beijing

0bjective To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals.Methods A cross-sectional investigation was used to screen the outpatients,and depression was diagnosed according to Mini International Neuropsyehiatric Interview (MINI).Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics.Results Among 248 cases of depression,30(12.1%)were referred to psychiatrists,28(8.9%)managed with antidepressant or sedative hypnotics.The identification rate of depression by physicians was 21.0%.and the identification rate by neurologist was 40.4%,which is higher than the rate by cardiologist(22.4%),gastrointestinal physician(3.8%)and gynecologist(2.0%)(χ2=61.077,P<0.05).Visiting neurology department,severity of life impairment,with psychotic distress history,hadpsychological complaints.co-morbidity with anxiety related to the physician's identification of depression.Among the psychological complaints.only mood disorder and insomnia were related to the physician'sidentification of depression.Conclusions The level of depression identification by physician was low,the level of neurologist wag higher than that of cardiologist,gastrointestinal physician and gynecologist.The patient with serious life impairment,psychotic distress history,mood disorder and insomnia complaints was asily to be identified.