心血管专科医院患者常见焦虑、抑郁、躯体化症状现况调查-东南大学学报医学版

心血管专科医院患者常见焦虑、抑郁、躯体化症状现况调查

单位：1. 郑州市第七人民医院/郑州市心血管病医院心血管内科, 河南郑州 450000;
2. 北京大学人民医院心血管内科, 北京 100000

分类号：R749.72;R749.4

出版年·卷·期（页码）：2020·39·第五期（608-614）

摘要：

目的:了解心血管专科医院心血管内科门诊和住院患者常见心理障碍的流行病学特征。方法:连续纳入2018年1月至2020年1月就诊于郑州市心血管病医院心血管内科门诊和住院患者,对其行9条目患者健康问卷(PHQ-9) 、广泛性焦虑问卷(GAD-7) 、躯体化症状自评量表调查。分析就诊患者焦虑、抑郁、躯体化症状的发生率、分布特征及严重程度,采用多因素线性回归分析躯体化症状的相关因素。结果:2年间共有6 643例患者完成心理评估,平均年龄(56.2±20.1)岁,男性占49.8%。存在抑郁症状的比例为31.18%,重度比例是0.88%;存在焦虑症状的比例是30.46%,重度比例是2.84%;存在躯体化症状的比例是72.7%,重度躯体化症状占1.77%。门诊患者焦虑、抑郁症状发生率显著高于住院患者,焦虑分别占47.3%、27.3%,抑郁分别占48.9%、27.9%。多因素线性回归分析显示,PHQ-9评分(OR=1.120,95%CI 1.177~1.357,P<0.001)和GAD-7 评分(OR=1.055,95%CI 1.043~1.208,P<0.001)是躯体化症状的独立相关因素。结论:心血管专科医院心血管内科存在大量焦虑、抑郁及躯体化症状的患者,并以轻中度症状为主,随着抑郁、焦虑问题的加重躯体化症状表现更为明显。提示应加强关注心血管内科患者的心理问题。

Objective: To investigate the epidemiological characteristics of common psychological disorders in outpatients and inpatients who visited the cardiology department of cardiovascular specialty hospitals. Methods: The patients visited the Department of Cardiology of Zhengzhou Cardiovascular Disease Hospital because of cardiovascular related discomfort from January 2018 to January 2020 were admitted. After informed consent, the patients would fill out the Patient Health Questionnairesc(PHQ)-9, Gneralized Anxiety Disorder Scale(GAD-7), and Somatic self-rating Scale with the assistance of medical staff trained and qualified as national second-level psychologists. The incidence, distribution and severity of psychological disorders in patients were analyzed,the related factors of somatic symptoms were analyzed by multivariate Logistic linear regression. Results: A total of 6 643 patients were admitted in 2 years for psychological evaluation,the average age was (56.2±20.1) years old, male accounted for 49.8%. The proportion of depressive symptoms in cardiology patients was 31.18%, and the severe ratio was 0.88%. The proportion of patients with anxiety symptoms was 30.46%, and the severe ratio was 2.84%. 72.7% of patients had somatic symptoms, of which 1.77% were severe. The detection rates in outpatients were significantly higher than those in inpatients, with anxiety accounting for 47.3% and 27.3%, and depression accounting for 48.9% and 27.9%, respectively. Multivariate Logistic linear regression analysis showed that PHQ-9 score(OR=1.120, 95% CI 1.17-1.357, P<0.001) and GAD-7 score (OR=1.055, 95% CI 1.043-1.208,P<0.001)were Independent related factors of somatic symptoms. Conclusion: There are a large number of patients with anxiety, depression and somatic symptoms in the department of cardiology of cardiovascular hospital, and the symptoms are mainly mild and moderate.With the aggravation of depression and anxiety, the somatic symptoms will become more obvious.It suggests that the psychological problems of cardiovascular patients should be paid more attention.

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