• 四川大學(xué)華西醫(yī)院心理衛(wèi)生中心（成都，610041）;

【摘要】　目的　 了解成都市綜合醫(yī)院門診患者抑郁障礙和焦慮障礙的患病率及門診醫(yī)生的識別率。　方法　 2007年4-5月應(yīng)用醫(yī)院焦慮抑郁量表（Hospital Anxiety and Depression Scale，HADS）、患者健康問卷（Patient Health Questionnaire 15-Item，PHQ-15）對在四川大學(xué)華西醫(yī)院和華西第二醫(yī)院神經(jīng)內(nèi)科、消化內(nèi)科、婦科和心血管內(nèi)科門診就診的685例患者進行篩查。HADS≥8分者進入精神科訪談，由精神科醫(yī)生使用國際神經(jīng)精神科簡式訪談問卷進行診斷。　結(jié)果　 綜合醫(yī)院門診患者抑郁障礙校正后的現(xiàn)患率和終身患病率分別為19.26%和22.32%，焦慮障礙校正后的現(xiàn)患率和終身患病率分別為9.16%和9.63%。各科患病率不同，科室間患病率的差異有統(tǒng)計學(xué)意義。門診醫(yī)生的識別率為10.57%。　結(jié)論　 成都市綜合醫(yī)院門診患者抑郁障礙和焦慮障礙的患病率較高，識別率有待提高。
【Abstract】　Objective　 To investigate the prevalence of depressive disorders and (or) anxiety disorders and physicians’ detection rate of these disorders in general hospitals in Chengdu.　Methods　 From April to May, 2007, a hospital-based cross-sectional survey was conducted in neurology, gastrointestinal, gynecology and vasculocardiology departments in West China Hospital and West China Second Hospital. Outpatients were screened by using Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire 15-Item (PHQ-15). Psychiatrists interviewed subjects whose score of HADS were 8 and above and made diagnoses by using Mini International Neuropsychiatric Interview (MINI) according to the criteria of Diagnostic and Statistical Manual of Mental Health Disorders 4th Edition (DSM-IV).　Results　 The adjusted current and lifetime prevalence of depressive disorders were 19.26% and 22.32%, respectively, and those of anxiety disorders were 9.16% and 9.63%, respectively. The prevalence of depressive disorders and/or anxiety disorders among four departments had statistically significant difference. The detection rate of these disorders by outpatient physicians was 10.57%.　Conclusion　 Prevalence of depressive disorders and anxiety disorders among outpatients in West China Hospital and West China Women and Children Hospital is high, and the rate of physicians’ detection needs to be improved.

引用本文： 李曉靖,張嵐,李斌. 成都市綜合醫(yī)院門診患者抑郁焦慮障礙診治狀況研究. 華西醫(yī)學(xué), 2011, 26(2): 192-194. doi: 復(fù)制

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2. 　Williams LS, Ghose SS, Swindle RW. Depression and other mental health diagnoses increase mortality risk after ischemic stroke[J]. Am J Psychiatry, 2004, 161(6): 1090-1095.
3. 　Kisely SR, Goldberg DP. Physical and psychiatric comorbidity in general practice[J]. Brit J Psychiatry, 1996, 169(2): 236-242.
4. 　Cassem EH. Depressive-disorders in the medically ill: an overview[J]. Psychosomatics, 1995, 36(2): S2-S10.
5. 　Arolt V, Rothermundt M. Depressive disorder in patients with somatic illnesses[J]. Nervenarzt, 2003, 74(11): 1033-1052.
6. 　肖澤萍, 嚴和駿, 肖世富, 等. 綜合性醫(yī)院門診病人抑郁障礙的研究[J]. 中華醫(yī)學(xué)雜志, 1999, 79(5): 329-331.
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8. 　Kroenke K, Spitzer RL, Williams JB. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms[J] . Psychosom Med, 2002, 64(2): 258-266.
9. 　司天梅, 舒良, 黨衛(wèi)民, 等. 簡明國際神經(jīng)精神訪談中文版的臨床信效度[J]. 中國心理衛(wèi)生雜志, 2009, 23 (7): 493-497.
10. 　Pakriev S, Kovalev J, Mozhaev M. Prevalence of depression in a general hospital in Izhevsk, Russia[J]. Nord J Psychiat, 2009, 63(6): 469-474.
11. 　何燕玲, 馬弘, 張嵐, 等. 綜合醫(yī)院就診者中抑郁焦慮障礙的患病率調(diào)查[J]. 中華內(nèi)科雜志, 2009, 48 (9): 748-751.
12. 　高志勤, 余海鷹, 白戰(zhàn)生, 等. 情感性精神障礙的氣候影響——中國7地區(qū)流行病學(xué)資料再分析[J]. 臨床精神醫(yī)學(xué)雜志, 2003, 13 (1): 8-9.
13. 　Stella F, Banzato CE, Barasnevicius Quagliato EM, et al. Depression in patients with Parkinson’s disease: impact on functioning[J]. J Neurol Sci, 2008, 272(1-2): 158-163.
14. 　Cigognini MA, Furlanetto LM. Diagnosis and pharmacological treatment of depressive disorders in a general hospital[J]. Rev Bras Psiquiatr, 2006, 28(2): 97-103.
15. 　Rentsch D, Dumont P, Borgacci S, et al. Prevalence and treatment of depression in a hospital department of internal medicine[J]. Gen Hosp Psychiatry, 2007, 29(1): 25-31.
  1. 1. 　Sullivan MD, LaCroix AZ, Baum C, et al. Functional status in coronary artery disease: a one-year prospective study of the role of anxiety and depression[J]. Am J Med, 1997, 103(5): 348-356.
  2. 2. 　Williams LS, Ghose SS, Swindle RW. Depression and other mental health diagnoses increase mortality risk after ischemic stroke[J]. Am J Psychiatry, 2004, 161(6): 1090-1095.
  3. 3. 　Kisely SR, Goldberg DP. Physical and psychiatric comorbidity in general practice[J]. Brit J Psychiatry, 1996, 169(2): 236-242.
  4. 4. 　Cassem EH. Depressive-disorders in the medically ill: an overview[J]. Psychosomatics, 1995, 36(2): S2-S10.
  5. 5. 　Arolt V, Rothermundt M. Depressive disorder in patients with somatic illnesses[J]. Nervenarzt, 2003, 74(11): 1033-1052.
  6. 6. 　肖澤萍, 嚴和駿, 肖世富, 等. 綜合性醫(yī)院門診病人抑郁障礙的研究[J]. 中華醫(yī)學(xué)雜志, 1999, 79(5): 329-331.
  7. 7. 　葉維菲, 徐俊冕. “綜合性醫(yī)院焦慮抑郁量表”在綜合性醫(yī)院病人中的應(yīng)用與評價[J]. 中國行為醫(yī)學(xué)雜志, 1993, 2(3): 17-19.
  8. 8. 　Kroenke K, Spitzer RL, Williams JB. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms[J] . Psychosom Med, 2002, 64(2): 258-266.
  9. 9. 　司天梅, 舒良, 黨衛(wèi)民, 等. 簡明國際神經(jīng)精神訪談中文版的臨床信效度[J]. 中國心理衛(wèi)生雜志, 2009, 23 (7): 493-497.
  10. 10. 　Pakriev S, Kovalev J, Mozhaev M. Prevalence of depression in a general hospital in Izhevsk, Russia[J]. Nord J Psychiat, 2009, 63(6): 469-474.
  11. 11. 　何燕玲, 馬弘, 張嵐, 等. 綜合醫(yī)院就診者中抑郁焦慮障礙的患病率調(diào)查[J]. 中華內(nèi)科雜志, 2009, 48 (9): 748-751.
  12. 12. 　高志勤, 余海鷹, 白戰(zhàn)生, 等. 情感性精神障礙的氣候影響——中國7地區(qū)流行病學(xué)資料再分析[J]. 臨床精神醫(yī)學(xué)雜志, 2003, 13 (1): 8-9.
  13. 13. 　Stella F, Banzato CE, Barasnevicius Quagliato EM, et al. Depression in patients with Parkinson’s disease: impact on functioning[J]. J Neurol Sci, 2008, 272(1-2): 158-163.
  14. 14. 　Cigognini MA, Furlanetto LM. Diagnosis and pharmacological treatment of depressive disorders in a general hospital[J]. Rev Bras Psiquiatr, 2006, 28(2): 97-103.
  15. 15. 　Rentsch D, Dumont P, Borgacci S, et al. Prevalence and treatment of depression in a hospital department of internal medicine[J]. Gen Hosp Psychiatry, 2007, 29(1): 25-31.