北京市综合医院成人门诊多种躯体症状检出率及特点

中华精神科杂志 Pub Date : 2019-08-05 DOI:10.3760/CMA.J.ISSN.1006-7884.2019.04.004

Xiang-yun Yang, Zhanjiang Li, Pengchong Wang, L. Tan, Xiaoqi Li, Yongdong Hu, Xueqing Han, Jianhua He, Jian Gao, Ruixiang Cao, Yi Zhang, Si Zu, F. Cui, Shaojuan Cui, Jing Sun

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The patients were divided into multiple somatic symptoms group (SOM+group, PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group, PHQ-15<10). The detection rate of multiple somatic symptoms was calculated. Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic, course of disease, cumulative number of visits, and the total score of PHQ-9. \n \n \nResults \nThe overall detection rate of multiple somatic symptoms was 32.67% (489/1 497) in the three hospitals, and the highest was found in the department of digestive medicine (37.74%, 191/506). There were significant differences in gender (χ2=36.85, P<0.01), working status (χ2=19.78, P<0.01), visiting department (χ2=9.64, P<0.01), first visiting/repeated visiting (χ2=6.67, P<0.01), and the total score of PHQ-9 (χ2=231.52, P<0.01). The detection rate of female patients was higher than that of male patients. 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引用次数: 1

摘要

目的探讨心内科、神经内科和胃肠内科成人门诊患者多重躯体症状的检出率及临床特点。方法对北京市朝阳医院、北京市安贞医院和北京市同仁医院的1 497例患者进行持续调查和筛查，收集患者的一般人口学资料和疾病相关信息。采用患者健康问卷-15 (PHQ-15)和患者健康问卷-9 (PHQ-9)对躯体症状和抑郁症状进行评估。将患者分为多重躯体症状组(SOM+组，PHQ-15≥10)和非多重躯体症状组(SOM-组，PHQ-15<10)。计算多种躯体症状的检出率。采用偏相关分析分析PHQ-15与人口学、病程、累计就诊次数、PHQ-9总分的相关性。结果3家医院多躯体症状的总检出率为32.67%(489/1 497)，其中消化内科检出率最高(37.74%，191/506)。调查对象在性别(χ2=36.85, P<0.01)、工作状态(χ2=19.78, P<0.01)、就诊科室(χ2=9.64, P<0.01)、首次访诊/多次访诊(χ2=6.67, P<0.01)、PHQ-9总分(χ2=231.52, P<0.01)方面存在显著差异。女性患者的检出率高于男性患者。退休患者和无日常稳定工作的患者检出率高于有日常稳定工作的患者。复诊患者的检出率高于初诊患者。病程(r=0.07, P<0.05, Bonferroni校正)和PHQ-9总分(r=0.66, P<0.05, Bonferroni校正)与躯体症状严重程度呈正相关。结论综合医院多躯体症状检出率较高，以消化门诊最高，女性、退休、失业、复诊及有抑郁症状的患者检出率较高。抑郁症状、病程与躯体症状严重程度呈正相关。关键词:躯体形式障碍;问卷调查;门诊病人;医院,一般

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Detection rate and characteristics of adult outpatients with multiple somatic symptoms of general hospital in Beijing

Objective To explore the detection rate and clinical characteristics of multiple somatic symptoms among adult outpatients in cardiology, neurology and GI clinics. Methods The general demographic data and disease-related information of 1 497 patients in Beijing Chaoyang Hospital, Beijing Anzhen Hospital and Beijing Tongren Hospital were collected through continuous inquiry and screening. Physical symptoms and depressive symptoms were assessed by Patient Health Questionnaire-15 (PHQ-15) and Patient Health Questionnaire-9 (PHQ-9). The patients were divided into multiple somatic symptoms group (SOM+group, PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group, PHQ-15<10). The detection rate of multiple somatic symptoms was calculated. Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic, course of disease, cumulative number of visits, and the total score of PHQ-9. Results The overall detection rate of multiple somatic symptoms was 32.67% (489/1 497) in the three hospitals, and the highest was found in the department of digestive medicine (37.74%, 191/506). There were significant differences in gender (χ2=36.85, P<0.01), working status (χ2=19.78, P<0.01), visiting department (χ2=9.64, P<0.01), first visiting/repeated visiting (χ2=6.67, P<0.01), and the total score of PHQ-9 (χ2=231.52, P<0.01). The detection rate of female patients was higher than that of male patients. The detection rates of retired patients and patients who had no daily stable work were higher than patients who had daily stable work.The detection rate of re-visited patients was higher than that of first-visited patients. The illness duration (r=0.07, P<0.05, Bonferroni correction) and the total score of PHQ-9 (r=0.66, P<0.05, Bonferroni correction) were positively correlated with the severity of somatic symptoms measured by PHQ-15. Conclusions The detection rate of multiple somatic symptoms was high in general hospitals, especially highest in digestive outpatient clinics, and significantly higher in female, retired, unemployed, re-visited and patients who have depressive symptoms. Depressive symptoms and the illness duration were positively correlated with the severity of somatic symptoms. Key words: Somatoform disorders; Questionnaires; Outpatients; Hospitals, General

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来源期刊

中华精神科杂志

CiteScore

0.70

自引率

0.00%

发文量

7134

期刊介绍： Chinese Journal of Psychiatry was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry.Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals,Chinese Journal of Neurology, and Chinese Journal of Psychiatry. The journal is indexed by many indexing tools, such as CA (Chemical Abstracts, USA), ISTIC, PKU, Wanfang Data (China), CSCD (Chinese Science Citation Database, China), etc. The journal is available both in print and online.