消化科门诊患者抑郁和焦虑障碍的现况调查

目的 了解北京地区综合医院消化科门诊患者抑郁障碍和焦虑障碍的患病率和诊疗状况.方法 对2007年5-6月在北京三所大型综合医院消化科就诊的年龄≥18岁的患者517例,应用医院焦虑抑郁量表(HADS)筛查,评分≥8分者由精神病科医生根据国际神经精神科简式访谈问卷(M.I.N.I.)做出临床诊断.同时由消化科医生在对HADS评分不知情的状况下作出疾病诊断以及处理意见.结果消化科门诊患者中抑郁和焦虑障碍的患病率为15.3%,抑郁障碍的患病率为12.0%,焦虑障碍为6.4%,抑郁合并焦虑障碍为3.0%.不同性别、不同年龄患者中抑郁障碍和焦虑障碍的患病率差异无统计学意义(P>0.05).胃炎和消化功能紊乱性疾病是焦虑抑郁患者中主要诊断,分别占30.6%和26.4%.消化科医生对抑郁和焦虑障碍的正确识别率为2.8%.结论 北京地区综合医院消化内科门诊患者中抑郁和焦虑障碍的患病率较高,消化科医生的识别率较低.

The prevalence of depression and anxiety in gastrointestinal out-patients of tertiary general hospitals in Beijing

Objective To explore the prevalence and physician's recognition of depression and anxiety disorder in gastrointestinal out-patients of three tertiary general hospitals in Beijing. Methods A hospital-based cross-sectional survey was conducted in the gastrointestinal out-patient departments of three tertiary general hospitals in Beijing from May to June 2007. Total 517 subjects were recruited consecutively within a one month period. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Results Among the 517 cases, 301 had a HADS score of 8 and above and 244 were interviewed by psychiatrists; the response rate was 81.1%. The prevalence according to Diagnostic and Statistical Manual of Mental Disorders Fourth edition of depressive disorders and anxiety disorders in gastrointestinal outpatients were 15.3%, depressive disorders were 12. 0%, anxiety disorders were 6. 4%, depression combined anxiety disorder was 3. 0%. The prevalence of depression, anxiety, depression combined anxiety were not different between genders (x2 = 0. 874, x2 = 1.797,x2 =0.518, P >0.05) and among different age group ( 18-34, 35-54, ≥55 years old) (x2 = 1. 084,2 = 2. 735, 2 = 0. 350, P 0. 05 ). Gastritis and gastrointestinal dysfunction were the major diagnoses in patients with depression and/or anxiety disorders, the rates were 30. 6% and 26. 4% respectively. The rate of identification of depression and anxiety disorder by physicians was 2. 8%. Conclusion Gastrointestinal out-patients have a high prevalence of depression and anxiety disorder and the rate of identification by physicians was very low.