Fu Chao-Wei, Xu Biao, Zhan Si-Yan, Luan Rong-Sheng, Chen Wei-Qing
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 20032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2006 Sep;27(9):803-7.
To describe the prevalence of depressive and/or anxiety symptoms in patients with some neurological diseases in the general hospitals of major cities in China.
A hospital-based cross-sectional study was conducted in four big cities in China in 2004. 1197 eligible subjects with Stroke, Parkinson's disease and Epilepsy were recruited from the outpatient or inpatient departments within three months. Face-to-face interview was used in data collection together with the self-completed Hospital Anxiety and Depression (HAD) scale for depressive and/or anxiety symptom, were screened. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with Hamilton anxiety scales and Hamilton depression scales by the licensed psychologists or psychiatrists.
The prevalence rates of "self-scaled" depressive and/or anxiety symptoms were 19.5%, 24.1% and 21.9% respectively in patients with stroke, Parkinson's disease and epilepsy. Among cases with "self-scaled" depressive and/or anxiety symptoms, the prevalence rates of depressive and/or anxiety symptoms were 50.8%, 73.1% and 38.6% respectively; less than 17% of subjects had obtained a diagnosis of depressive disorders and had been treated but only 4% of the subjects having obtained a diagnosis of anxiety disorders and been treated prior to the study. The sex specific prevalence varied over the somatic diseases. In patients with Parkinson's disease, the prevalence of "self-scaled" anxiety symptom was significantly higher in females than in males (21.1% vs. 12.2%; chi2 = 5. 679, P = 0.017),and the total prevalence of "self-scaled" depressive and/or anxiety symptoms was also higher in female (30.3% vs. 20.5%; chi2 = 4.978, P = 0.026); in patients with stroke while the prevalence of depressive and anxiety symptoms in female was higher than that in male (52.2% vs. 20.0%; chi2 = 6.009, P = 0.014), and a higher prevalence of depressive symptoms in female patients with epilepsy was also reported (32.4% vs. 13.6%; chi2 = 4.108, P = 0.043).
It was of great importance to remind the healthcare providers and health policy makers that high prevalence of depressive and/or anxiety symptoms was found in patients with somatic diseases but with low percentages of previous diagnosis or treatment in the departments of neurology at the general hospitals in urban China.
描述中国大城市综合医院中部分神经系统疾病患者抑郁和/或焦虑症状的患病率。
2004年在中国四个大城市开展了一项基于医院的横断面研究。在三个月内从门诊或住院部招募了1197例符合条件的中风、帕金森病和癫痫患者。采用面对面访谈收集数据，并使用自行填写的医院焦虑抑郁量表（HAD）筛查抑郁和/或焦虑症状。HAD得分在9分及以上的受试者由持牌心理学家或精神科医生用汉密尔顿焦虑量表和汉密尔顿抑郁量表进一步评估抑郁和/或焦虑障碍。
中风、帕金森病和癫痫患者中“自评”抑郁和/或焦虑症状的患病率分别为19.5%、24.1%和21.9%。在有“自评”抑郁和/或焦虑症状的病例中，抑郁和/或焦虑症状的患病率分别为50.8%、73.1%和38.6%；不到17%的受试者被诊断为抑郁障碍并接受过治疗，但在研究前只有4%的受试者被诊断为焦虑障碍并接受过治疗。特定性别的患病率在不同躯体疾病中有所不同。在帕金森病患者中，“自评”焦虑症状的患病率女性显著高于男性（21.1%对12.2%；χ2 = 5.679，P = 0.017），“自评”抑郁和/或焦虑症状的总患病率女性也更高（30.3%对20.5%；χ2 = 4.978，P = 0.026）；在中风患者中，女性抑郁和焦虑症状的患病率高于男性（52.2%对20.0%；χ2 = 6.009，P = 0.014），癫痫女性患者抑郁症状的患病率也较高（32.4%对13.6%；χ2 = 4.108，P = 0.043）。
重要的是要提醒医疗服务提供者和卫生政策制定者，在中国城市综合医院的神经内科，躯体疾病患者中抑郁和/或焦虑症状的患病率很高，但先前诊断或治疗的比例较低。
