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目的了解天津市综合医院住院患者抑郁障碍的流行情况以及医生对抑郁障碍的认识和处理情况。方法随机选择3家三级和2家二级综合医院作为调查现场。由培训合格的12名调查员使用“简明国际神经精神访谈(MINI)中文版”的心境障碍部分和自编的“综合医院住院患者抑郁障碍调查表”进行抑郁障碍及其识别和治疗情况评估。共完成有效调查1 200例。结果抑郁障碍现患率为12.3%(95%CI:10.6%~14.3%),其中,重性抑郁障碍、心境恶劣障碍、其他抑郁障碍总的现患率分别为5.1%(95%CI:4.0%~6.5%)、3.6%(95%CI:2.7%~4.8%)、5.0%(95%CI:3.9%~6.4%)。抑郁障碍正确识别率为13.5%(95%CI:8.9%~19.9%),正确治疗率仅1.1%(95%CI:0.2%~5.9%)。在三级医院住院、婚姻状况不良、近1年住院次数≥3次、近半年失能天数较多、躯体健康状况自我评分较低是综合医院住院患者现患抑郁障碍的风险因素。结论天津市综合医院住院患者抑郁障碍现患率高,但临床识别和治疗率低。
Objective To understand the prevalence of depression in hospitalized patients in Tianjin General Hospital and the doctors’ understanding and treatment of depression. Methods Three tertiary hospitals and two secondary general hospitals were randomly selected as the survey site. The 12 trained investigators used the “Mental Disorders” section of the “Concise International Neuropsychiatric Interview (MINI) Chinese Version” and self-compiled “General Hospital Inpatients Depression Disability Questionnaire” to conduct a survey of depression and its identification and Treatment evaluation. A total of 1,200 valid investigations were completed. Results The prevalence of depressive disorder was 12.3% (95% CI: 10.6% -14.3%). The prevalence rates of major depressive disorder, dysthymia and other depressive disorders were 5.1% (95% CI: 4.0% 6.5%), 3.6% (95% CI: 2.7% -4.8%), 5.0% (95% CI: 3.9% -6.4%). The correct recognition rate of depression was 13.5% (95% CI: 8.9% -19.9%), and the correct treatment rate was only 1.1% (95% CI: 0.2% -5.9%). Hospitalization in tertiary hospitals, marital status is poor, the number of hospitalizations in recent 1 year ≥ 3 times, more disability days in the past six months, lower self-scores of physical health status is a risk factor for depression in current patients in general hospital. Conclusion The prevalence rate of depression in inpatients in Tianjin General Hospital is high, but the rate of clinical diagnosis and treatment is low.