沈阳市不同级别综合医院内科与中医科门诊抑郁障碍患病率比较

目的 了解沈阳市不同级别综合医院内科和中医科门诊抑郁障碍的患病率。方法 采用分层随机整群抽样的方法抽取沈阳市23家综合医院进行调查,共调查7448例年龄≥15岁的内科及中医科门诊患者。调查员在患者就医前使用12项一般健康问卷（GHQ-12）为筛查工具,将调查样本分为精神疾病高、中、低危险组,然后由精神科医生使用《美国精神疾病与行为障碍分类与诊断标准》（第四版）科研版轴Ⅰ障碍定式临床检查（SCID-I/P）对筛选高、中、低危险组100%、40%、10%的患者进行SCID诊断。结果 一级综合医院内科门诊任何抑郁障碍患病率显著高于二级医院（RR=1.30）;中医科门诊二级医院任何抑郁障碍患病率低于一级医院和三级医院（RR=2.09、0.52）。结论 内科和中医科门诊抑郁障碍一级医院患病率最高,三级医院重型抑郁障碍最多。应该加强初级医院抑郁障碍的防治工作,三级医院是重型抑郁障碍的防治重点。

The Prevalence of Depression of Internal and Chinese Traditional Medicine Outpatient Departments in Different Levels of General Hospitals

Objective To describe the prevalence of depression of internal and Chinese traditional medicine outpatient departments in different levels of general hospitals in Shenyang,and compare them.Methods Stratified multi-stage cluster randomization was used to identify 23 general hospitals for investigation,a total 7448 outpatients above 15 years of age in internal and Chinese traditional medicine outpatient departments have been investigated.Investigator used expanded version of General Health Questionnaire(GHQ-12)as a screen instrument to identify subgroups of the sample at high,moderate and low risk,then psychiatrists determined their diagnosis by using structured clinical interview for DSM-IV Axis I Disorders-Patient Edition(SCID-I/P)for 100% of high-risk and 40% of moderate-risk and 10% of low-risk subjects.Results Interal department,the overall current rate of any depression disorders in Grade one hospital was significantly higher than that in Grade two hospital(RR=1.30).Chinese tradition medicine department,the overall current rate of any depression disorders in Grade two hospital was lower than that in Grade one hospital and Grade three hospital(RR=2.09,0.52).Conclusion The prevalence of depression of internal outpatient departments and Chinese tradition medicine department of Grade one hospital was the highest and in internal department,the prevalence of depression was lower than Chinese tradition medicine department.We should enhance the prevention and the treatment of the depression in the primary hospital.