综合医院住院患者的一项联络会诊研究

【作者】 李练；

【导师】 魏镜；

【作者基本信息】 北京协和医学院 ， 心理医学， 2011， 硕士

【摘要】 目的：调查综合医院住院患者抑郁/焦虑障碍的患病情况、病房医生对抑郁/焦虑障碍的识别现状,探索适于联络工作使用的筛查工具。方法：以横断面研究的方法,在北京协和医院老年科病房、内分泌科1病房、消化科1病房连续纳入120例入院患者(≥14岁),使用医院焦虑抑郁量表CHADS)、综合生理心理社会健康评估量表(UPPSAQ)进行筛查并完成简明国际神经精神访谈(M.I.N.I.),同时收集上述病房患者的会诊资料。根据《美国精神障碍诊断与统计手册》第四版(DSM-IV)简明国际神经精神访谈的诊断结果,揭示综合医院住院患者抑郁/焦虑障碍的患病率并比较医院焦虑抑郁量表、综合生理心理社会健康评估量表及病房医生对抑郁/焦虑障碍进行识别的效度指标。结果：抑郁/焦虑障碍的现患率为15.2%,病房医生对抑郁/焦虑障碍识别的灵敏度为25.0%,显著低于医院焦虑抑郁量表和综合生理心理社会健康评估量表,后者(87.5%)比前者(81.3%)的灵敏度高。结论：综合医院住院患者抑郁/焦虑障碍患病率高于普通人群,病房医生的识别率与自评量表有差距。以评估筛查的方法推进联络工作时,综合生理心理社会健康评估量表比医院焦虑抑郁量表更敏感。更多还原

【Abstract】 Objective:To investigate the current prevalence and clinicians’recognition rate of depressive disorder/anxiety disorders in a general hospital and to explore a screening tool apply for the work of liaison.Methods:A cross-sectional study was conducted through consecutive sampling in inpatients of Peking Union Medical Collage Hospital during a month.120 inpatients (≥14 years-old) were recruited from department of geriatrics, department of endocrinology and department of gastroenterology. Hospital Anxiety and Depression Scale (HADS) and Union Physical Psychological Social Assessment Questionnaire (UPPSAQ) was used as screening tools for depressive and anxiety disorders, while the data of consultation has been collected. According to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Mini International Neuropsychiatric Interview (M.I.N.I.) was performed as the golden standard for diagnosing to compare the effectiveness of recognition of depressive and anxiety disorders between two self-rating scales and clinicians.Results:The current prevalence of depressive disorder/anxiety disorders was 15.2%. Doctors’recognition rate of depressive disorder/anxiety disorders (25.0%) was lower than both HADS (81.3%) and UPPSAQ (87.5%) significantly. UPPSAQ was more sensitive than HADS.Conclusions:The prevalence of depressive disorder/anxiety disorders in inpatients is higher than that in general population. Doctor’s recognition rate was lower than self-rating scales. UPPSAQ was more sensitive than HADS as a screening tool for liaison.更多还原