内科住院患者抑郁障碍现状及相关因素的横断面研究

目的探讨内科住院患者抑郁障碍的发生率、内科医师的识别率及其可能的影响因素。方法采用横断面的研究方法，首先应用ZUNG氏抑郁自评量表（SDS）对符合入组条件的371例内科住院患者进行筛查，对筛查阳性者（SDS粗分≥40分）和209／6的筛查阴性者（SDS粗分〈40分），再以美国《精神障碍诊断与统计手册第四版》DSM-Ⅳ作为金标准进行抑郁症的诊断，估算抑郁障碍的发生率及内科医师的识别率，并对相关的因素进行分析。结果内科患者抑郁检出率为占37．34％；SDS筛选阳性者118人和随机抽查20％的SDS筛选阴性者40人中经SCID诊断，现患抑郁障碍者共120人。内科医师识别率仅为3．33％。单因素分析发现：性别、年龄、文化程度、经济状况、躯体疾病既往史、住院时间、病程与抑郁的发生有关。多因素Logistic回归分析显示：性别、年龄、经济状况、疾病复发情况及住院时间是影响抑郁发生的主要因素。结论内科住院患者抑郁发生率高。性别、年龄、经济状况、疾病复发情况及住院时间是主要的影响因素。内科医师识别率低，提高内科医师对抑郁症的识别率和治疗率是当务之急。

A cross-sectional study on depressive disorder and related factors in medical inpatients

Objective To investigate the prevalence and possible influencing factors of depressive disorder in medical inpatients. Methods Three hundred and seventy one medical inpatients satisfying conditionings were first screened with the Self-rating Depression Scale （SDS） , then positive subjects screened and 20% of those screened negative were diagnosed with Structured Clinical Interview for DSM-Ⅳ Axis I Disorders（SCID）. The prevalence rate, recognization rate and possible influencing factors of depressive disorder were analysed. Results The incidence rate of depressive disorder in the medical inpatients was 37.34%. A total of 12 patients were diagnosed as depressive disorder. Resognizatin rate of physician was 3.33%. The univariate analysis showed that depressive disorder was associated with gender, age, education level, economic condition of family, past history of physical diseace, hospitalization and duration. Logistic regression analysis showed that gender,age,economic condition of family, relapse of illness and hospitalization time were the main factors. Conclusions The incidence rate of depressive disorder in the medical inpatients is high, which should be mainly influnced by gender,age, economic condition of family,relapse of illness and hospitalozation time.