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目的 调查高血压患者共病抑郁、焦虑障碍的患病率并探讨相关心理社会因素.方法 于2011年在北京市2个城市社区和1个农村社区以及吉林省4个城市社区和4个乡村社区共抽取高血压患者1 806例,应用复合性国际诊断问卷3.0中文版(Composite International Diagnostic Interview Version 3.0,CIDI-3.0)作为抑郁和焦虑障碍的诊断工具;采用自制一般资料问卷和简易应对方式问卷、社会支持评定量表、生活事件量表、简明幸福与生活质量满意度量表(Quality of Life Enjoyment and Satisfaction Questionnaire,Short Form,Q-LES-Q-SF)对高血压共病抑郁、焦虑障碍组和非共病抑郁、焦虑障碍组进行比较分析;采用多因素Logistic回归分析高血压共病抑郁、焦虑障碍的相关因素.结果 (1)两地高血压患者抑郁障碍患病率为6.5％ (117/1 806),焦虑障碍患病率为24.2％(437/1 806).(2)两地高血压患者中女性、无配偶者较男性[7.6％(88/1 162)与4.5％ (29/644)]、有配偶者[9.0％(29/324)与5.9％ (88/1 482)]抑郁障碍患病率较高,差异有统计学意义(x2=6.446、3.983,均P＜0.05);女性、年龄≤60岁、居住于农村、体力劳动、受教育年限≤9年者较男性[26.6％(309/1 162)与19.9％ (128/644)]、年龄＞60岁[28.7％(255/890)与19.9％ (182/916)]、居住于城市[26.9％(242/900)与21.5％ (195/906)]、脑力劳动[25.9％(289/1 114)与20.0％(83/416)]、受教育年限＞9年者[25.7％(333/1 296)与20.4％ (104/510)]焦虑障碍患病率较高,差异有统计学意义(x2=10.190、18.983、7.087、5.907、5.610,均P＜0.05).(3)共患抑郁障碍者与非抑郁者比较,主观支持分[(24.2 ±4.7)分与(26.1±4.4)分,t=-2.508]、支持利用度分[(6.2±2.1)分与(7.6±2.2)分,t=-3.951]、社会支持总分[(39.5±7.5)分与(43.1±6.7)分,t=-3.110]、积极应对维度分[(1.6±0.7)分与(1.9±0.7)分,Z=-2.356]、Q-LES-Q-SF评分[(47.4±7.8)分与(61.2±4.3)分,t=-15.615]低,负性事件刺激量[(38.8±59.3)分与(7.8±16.8)分,t=5.591]、生活事件总刺激量[(47.8±64.2)分与(20.2±33.0)分,Z=3.775]高,差异有统计学意义(均P＜0.05);共患焦虑障碍者比非焦虑障碍者主观支持分[(24.0±4.9)分与(25.1±4.6)分,t=-2.678]、社会支持总分[(40.0±7.2)分与(41.2±7.1)分,t=-2.063]、积极应对维度分[(1.5±0.6)分与(1.6±0.7)分,Z=-1.963]、Q-LES-Q-SF评分[(48.0±5.5)分与(53.9±5.5)分,t=-12.340]低,负性事件刺激量[(27.2±50.0)分与(10.6±21.5)分,Z=5.993]、消极应对维度分[(1.2±0.6)分与(1.1±0.6)分,Z =3.775]、生活事件总刺激量[(39.5±56.4)分与(23.9±36.0)分,Z=4.155]高,差异有统计学意义(均P＜0.05).(4)多因素Logistic分析:女性、负性事件刺激量与共病抑郁和焦虑障碍呈正相关(OR=1.689、1.017、1.431、1.070,均P＜0.05),Q-LES-Q-SF评分与共病抑郁和焦虑障碍呈负相关(OR=0.558、0.797,均P＜0.05).结论 两地高血压患者共病焦虑障碍的患病率高于抑郁障碍,女性、负性事件刺激可能是高血压共病心理障碍的危险因素,高生活满意度可能是保护性因素.“,”Objective To investigate the prevalence of hypertension comorbid of depression and anxiety disorder,and to explore the related psycho-social factors.Methods A total of 1 806 patients with hypertension were selected from urban and rural areas in Beijing and Jilin Province in 2011.The Chinese version of the Composite International Diagnostic Interview Version 3.0 (CIDI-3.0) was used to diagnose depression and anxiety disorder.Four additional questionnaires obtained demographic data,and data on coping style,social support,quality of life and degree of life satisfaction.Logistic regression analysis was used to explore the related factors of hypertension comorbid of depression and anxiety.Results (1) The prevalence rate of depression and anxiety disorder among patients with hypertension in Beijing and Jilin was 6.5％ (117/1 806) and 24.2％ (437/1 806),respectively.(2) The prevalence of depression among patients with hypertension was significantly higher in female patients and patients without a spouse (7.6％ (88/1 162) vs.9.0％ (29/324)) than male patients and that with a spouse (4.5％ (29/644) vs.5.9％ (88/1 482);x2 =6.446,3.983,both P ＜ 0.05).The prevalence of anxiety among patients with hypertension was significantly higher in patients of female gender,being 60 years of age or younger,living in rural areas,manual labor,having 9 or fewer years of education than in patients of male gender (26.6％ (309/1 162) vs.19.9％ (128/644)),being 60 years older(28.7％ (255/890) vs.19.9％ (182/916)),living in urban areas (26.9％ (242/900) vs.21.5％ (195/906)),mental work (25.9％ (289/1 114) vs.20.0％ (83/416)) and having 9 more years of education(25.7％ (333/1 296) vs.20.4％ (104/510);x2 =10.190,18.983,7.087,5.907,5.610,all P ＜ 0.05).(3) Compared with non-depression group,depression group had significantly lower scores on subjective support (24.2 ± 4.7 vs.26.1 ± 4.4,t =-2.508),support availability (6.2 ± 2.1 vs.7.6 ± 2.2,t =-3.951),total social suppot (39.5 ± 7.5 vs.43.1±6.7,t =-3.110),positive coping dimension (1.6±0.7 vs.1.9±0.7,Z=-2.356),Q-LES-Q-SF (47.4 ±7.8 vs.61.2 ±4.3,t =-15.615),and had significantly higher scores on amount of negative events stimulation (38.8 ± 59.3 vs.7.8 ± 16.8,t =5.591),total amount of life events stimulation (47.8 ± 64.2 vs.20.2 ± 33.0,Z =3.775;all P ＜ 0.05).Compared with non-anxiety group,anxiety group had significantly lower scores on subjective support (24.0 ± 4.9 vs.25.1 ± 4.6,t =-2.678),total social support (40.0 ± 7.2 vs.41.2 ± 7.1,t =-2.063),positive coping dimension (1.5 ± 0.6 vs.1.6 ± 0.7,Z =-1.963),Q-LES-Q-SF (48.0 ± 5.5 vs.53.9 ± 5.5,t =-12.340),and had significantly higher scores on amount of negative events stimulation (27.2 ± 50.0 vs.10.6 ± 21.5,Z =5.993),average negative coping dimension (1.2 ± 0.6 vs.1.1 ± 0.6,Z =3.775),total amount of life events stimulation (39.5 ± 56.4 vs.23.9 ± 36.0,Z =4.155;all P ＜ 0.05).(4) Logistic regression analysis showed female gender,negative events had significant positive correlation to concurrent depression and anxiety in patients with hypertension (OR =1.689,1.017,1.431,1.070,all P ＜ 0.05).High life satisfaction degree had significant negative correlation (OR =0.558,0.797,both P ＜ 0.05).Conclusion The prevalence of anxiety disorder is higher than that of depression in hypertensive patients in Beijing and Jilin.Female gender,negative events are possible risk factors for concurrent depression and anxiety in patients with hypertension,and high life satisfaction degree are possible protective factor.