心内科门诊患者躯体症状与焦虑、抑郁的相关分析

目的对在广州地区综合医院心内科门诊就诊的患者进行焦虑、抑郁症状和躯体症状的现状调查,并探讨躯体症状与焦虑、抑郁的相互关系。方法通过随机抽样从广州市卫生局抽取广州6家大型综合医院,采用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)和患者健康问卷(patient health questionnaire-15,PHQ-15)对906例在综合医院心内科门诊就诊的患者进行量表评定,统计患者焦虑、抑郁检出率及不同程度躯体症状患者焦虑、抑郁患病相对危险度。结果906例门诊患者中,焦虑、抑郁及焦虑、抑郁合并现患病率分别为12.6%、9.7%、16.6%。躯体症状与焦虑、抑郁的相关分析显示,PHQ-15总分、PHQ-15阳性症状数目与HADS总分(r=0.512,P<0.01;r=0.475,P<0.01)、HAD-A因子分(r=0.504,P<0.01;r=0.469,P<0.01)及HAD-D因子分(r=0.431,P<0.01;r=0.399,P<0.01)呈正相关。躯体症状轻度(PHQ-15,5～9分)、中度(PHQ-15,10～14分)、重度(PHQ-15,15～30分)患者焦虑患病的相对危险度(relative risk,RR)及95%可信区间(confidence interval,CI)分别为4.41(1.98～9.86)、13.95(6.38～30.51)、47.73(18.74～121.53);抑郁患病的相对危险度RR(95%CI)]分别为2.14(0.95～4.83)、6.96(3.12～15.51)、15.70(6.26～39.36);焦虑、抑郁合并患病的相对危险度RR(95%CI)]分别为3.56(1.59～7.95)、10.70(4.91～23.32)、32.66(13.68～78.02)。结论综合医院心内科门诊就诊患者焦虑、抑郁常见;躯体症状与焦虑、抑郁密切相关,躯体症状程度越重,躯体症状数目越多,患焦虑、抑郁相对危险度越高。

Correlative analysis between anxiety, depression and somatic symptoms in outpatients in cardiology clinic

Objectives To investigate the prevalence of anxiety, depression and somatic symptoms in outpatients in cardiology clinic of Guangzhou, and to analyze the relationship between anxiety, depression and somatic symptoms. Methods Within a cross-sectional survey, 906 outpatients from 6 general hospitals in Guangzhou randomly selected by Bureau of Health of Guangzhou Municipality were tested with the Hospital Anxiety and Depression Scale （HADS） and the Patient Health Questionnaire-15 （PHQ-15）. Prevalence of anxiety and depression, relative risks （RR） of anxiety and depression in patients with different severity somatic symptoms were investigated. Results Prevalence rates of anxiety, depression and anxiety combined with depression were 12.6% ,9.7% and 16.6% respectively in the 906 outpatients. Significant positive correlations were observed between PHQ-15 scores,PHQ-15 positive symptom nmnbers and HADS sores （r=0.S12, P〈0.01; r=0.475, P〈0.01）, HAD-A sores （r=0.504,P〈0.01; r=0.469, P〈0.01）, HAD-D sores （r=0.431, P〈0.01; r=0.399, P〈0.01）. Relative risks （RR） and 95% confidence intervals （CI） for patients with anxiety in low PHQ-15 scores （5-9）, medium PHQ-15 scores （10-14） and high PHQ-15 scores （15-30） were 4.41 （1.98-9.86）, 13.95 （6.38-30.51）, 47.73 （18.74-121.53） respectively; RRs （95% CI） for patients with depression were 2.14 （0.95-4.83）, 6.96 （3.12-15.51）, 15.70 （6.26-39.36） respectively; RRs （95% CI） for patients with anxiety combined with depression were 3.56 （1.59-7.95）, 10.70 （4.91-23.32）, 32.66 （13.68-78.02） respectively. Conclusions There is a high prevalence of anxiety and depression in outpatients in cardiology clinic,. Significant correlation is observed between anxiety, depression and somatic symptoms. The more severity the somatic symptoms are, the higher RRs of anxiety and depression are.