终末期肾功能衰竭透析病人的心理问题研究

采用综合性医院焦虑抑郁量表（ＨＡＤ）、Ｈａｍｉｌｔｏｎ抑郁和焦虑量表（ＨＡＭＤ、ＨＡＭＡ），以及日常生活能力量表（ＡＤＬ）对上海市三所综合性教学医院肾病科住院透析病人进行了透析前后对照研究，同时对这些病人采用ＣＣＭＤ－２的有关诊断标准进行临床诊断性会谈。结果发现，透析病人有较高的心理障碍罹患率（５７．４５％），其中透析前病人的心理问题更为多见，抑郁、焦虑症状的罹患率达８２．９８％。透析后病人的各量表评分均有显著下降（Ｐ＜０．０５），提示透析治疗本身对病人的心理状况有一定的影响。另外，对ＨＡＤ（自评量表）与ＨＡＭＡ、ＨＡＭＤ（他评量表）进行了一致性分析，发现ＨＡＤ与后两者之间有较好的相关性（ｒ＝０．７６和０．８２，Ｐ＜０．０５），提示ＨＡＤ是一个较可靠的量表。

Investigation on psychological distress of the dialystic patients with end-stage renal failure

The end-stage renal failure (ESRF)patients suffered from psychological distress are rather common (50-70%), especially in those who need receiving dialystic treatment,according to a series of research reports. The authors investigated 47 ESRF inpatients in three teaching hospitals in Shanghai , who are being treated by dialysis (including hemodialysis and peritoneal dialysis), using the Hospital Anxiety and Depression Scale (HAD), Hamilton Depression and Anxiety Scales (HAMD, HAMA), Activity of Daily Living Scale (ADL), and the mannual of Chinese Classification and Diagnostic Criteria of Mental Disorders (2nd edition, CCMD-2).The results showed that about 57. 45% of these investigated patients were suffering psychological disorders (e. g. depressive and anxiety disorders), particularly in those waiting to dialysis. Comparing the rating scores on the HAD, HAMA, HAMD and ADL before and after dialystic treatment in these patients, there were significant reductions on these rating scales which reflected partly the severity, of patients'motional problems. In addition, there was a good correlation between HAD and HAMD and HAMA (r=0. 76, r= 0. 82). In accordance with some findings in this investigation, the authors suggested that physicians and psychiatrist should draw more attention to the ESRF patients with psychological problems.