【作者】 陈曦； 张红伟； 赵瑶； 许琰； 孙闪华； 高志东； 贺晓新；

【机构】 北京结核病控制研究所；

【摘要】 目的了解北京市16区(县)1105例新登记肺结核患者抑郁、焦虑的心理状况。方法 2015年1-7月,对北京市所辖16个区(县)1105例新登记肺结核患者进行问卷调查,采用整群抽样的调查方法 ,运用面对面的调查方式,调查问卷由北京结核病控制研究所联合北大六院精神卫生学方面的有关专家共同设计完成。调查肺结核患者的性别、年龄、学历、职业及吸烟饮酒史,同时使用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持量表(SSRS)了解结核病患者的抑郁、焦虑现况及相关的社会支持现状。统计学方法采用方差分析和卡方检验来分析结果 ,显著性水平为P<0.05。实际发放1 1 19份调查问卷,共计收回有效问卷1105份。结果 1105名肺结核患者抑郁、焦虑症状检出率分别为29.8%(329/1105)和13.5%(149/1105)。患者平均年龄(35.7±13.8)岁。男性占67.1%(742/1105),男性与女性比例是2:1;文化程度高中及以下占61.7%(682/1105),已婚占55.0%(608/1105),工人、农民、学生、干部和教师占60.2%(665/1105)、本地户籍占47.2%(522/1105)、城镇职工、居民和新农合医保占58.6%(648/1105);近一年来63.4(701/1105)与家人一起居住、28.7%(317/1105)与邻居之间很少关心或者不交往、10.3%(114/1105)与同事之间很少关心,不交往;69.1%(764/1105)遇到烦恼问题一般不求助别人、30.3%(335/1105)的肺结核患者从不参加集体活动。多因素分析结果显示,女性(OR为1.75,95%可信区间是1.32-2.30)、35岁以上(OR为1.82,95%可信区间是1.39-2.39)、家庭年收入在5万以下(OR为1.57,95%可信区间是1.19-2.06)、遇到烦恼不会倾诉(OR为1.41,95%可信区间是1.05-1.90)与抑郁的发生有统计学意义,P值分别为<0.0001,<0.0001,0.0014,0.0217;家庭年收入在5万以下(OR为1.69,95%可信区间是1.17-2.43)、遇到烦恼不会倾诉(OR为1.80,95%可信区间是1.19-2.74)与焦虑的发生有统计学意义,P值分别为0.0052和0.0058。患者抑郁、焦虑得分与主观支持、客观支持、支持利用度、支持总分之间呈显著负相关(P<0.05)。结论北京市肺结核患者中抑郁的患病率高于焦虑,患者心理健康状况受到社会支持的影响,同时,女性,高年龄以及家庭经济状况较差的患者心理疾患发生风险高。今后在肺结核患者抗结核治疗的同时,拓宽健康教育途径,加强对患者的心理疏导等心理干预措施,提高全社会对肺结核患者尤其是女性肺结核患者的支持度。更多还原

【Abstract】 Objective To investigate the prevalence rates of mental disorders and its related factors among new registered tuberculosis(TB) outpatients.Methods 1105 TB outpatients from 1 January to 30 June in 2015 were enrolled.The questionnaire was designed by professors and the related information was collected through interviewing the pateints.1105 questionnairs were collected from 1119 investigated patients.Epidata 3.1 and SAS9.2 software were used to input and analyze the data.Logistic multivariate regression analysis was conducted to analysis the suspicious factors about Anxitey/Depression.Results The detection rates of depression and anxiety were 29.8%(329/1105) 和 13.5%(149/1105.The mean age was(42.04±5.37) years.61.7%(682/1105),of which67.1% were male,32.9%were female,the ratio is 2:l.of which 61.7%(682/1105)were high school and below,55.0%(608/1105)were married,60.2%(665/1105)were injob,47.2%(522/1105) were local registered residence,58.6%(648/1105) were three major public health insurance.In recent one years 63.4(701/1105) Living together with family,28.7%(317/1105) little contacting with neighbors,10.3%(114/1105) little contacting with colleague,69.1%(764/1105) Generally doing not ask others for help,30.3%(335/1105) rarely participating in group activities.Multivariate logistic regression analysis showed that TB patients with female(OR=1.75,95%CI 1=1.32-2.30,P=0.0016),Generally doing not ask others for help(OR=1.55,95%CI=1.04-2.29.P<0.0001),Over 35 years(OR=1.82,95%CI=1.39-2.39.P<0.0001),Annual household income <50000(OR=1.57,95%CI=1.19-2.06.P=0.0014),rarely participating in group activities(OR=1.41,95%CI=1.05-1.90.P=0.0217)had high risk of depression.Annual household income<50000(OR=1.69,95%CI=1.17-2.43.P=0.0052),rarely participating in group activities(OR=1.80,95%CI=1.19-2.74.P=0.0058)had high risk of anxiety.The score of subjective support,objective support,support was negatively related to depression and anxiety.Conclusions TB patients had obviously social supports,female,age and family economic situation with mental disorders occur high risk.Suggest to provide psychological intervention in the anti-tuberculosis treatment at the same time,broaden the ways of health education,strengthen the patient’s psychological counseling,psychological intervention measures,improve the degree of social support for female patients with pulmonary tuberculosis.更多还原