Härter Martin, Baumeister Harald, Reuter Katrin, Jacobi Frank, Höfler Michael, Bengel Jürgen, Wittchen Hans-Ulrich
Department of Psychiatry and Psychotherapy, Section of Clinical Epidemiology and Health Services Research, Freiburg University Medical Center, Freiburg, Germany.
Psychother Psychosom. 2007;76(6):354-60. doi: 10.1159/000107563.
Although it is well established that chronic somatic diseases are significantly associated with a wide range of psychopathology, it remains unclear to what extent subjects with chronic somatic diseases are at increased risk of experiencing mental disorders. The present epidemiological study investigates age- and sex-adjusted 12-month prevalence rates of mental disorders in patients with cancer, and musculoskeletal, cardiovascular and respiratory tract diseases, based on comprehensive physicians' diagnoses and compared with physically healthy probands.
Prevalence rates were calculated from two large epidemiological surveys. These studies investigated inpatients and patients from the general population with cancer (n = 174) and musculoskeletal (n = 1,416), cardiovascular (n = 915) and respiratory tract diseases (n = 453) as well as healthy controls (n = 1,083). The prevalence rates were based on the Munich Composite International Diagnostic Interview, a standardized interview for the assessment of mental disorders.
Prevalence rates were very similar for inpatients (43.7%) and patients from the general population (42.2%). The adjusted odds ratios (OR) of patients with chronic somatic diseases were significantly elevated for mental disorders in comparison with healthy probands (OR: 2.2). Mood, anxiety and somatoform disorders were most frequent. The prevalence rates did not differ significantly between the somatic index diseases. The number of somatic diseases per patient had a higher association with mental disorders.
There is a strong relationship between chronic somatic diseases and mental disorders. A future task is to improve the care of mental disorders in patients with chronic physical illness, specifically with multimorbid conditions.
虽然慢性躯体疾病与广泛的精神病理学显著相关已得到充分证实,但慢性躯体疾病患者患精神障碍的风险增加到何种程度仍不清楚。本流行病学研究基于医生的综合诊断,调查了癌症、肌肉骨骼疾病、心血管疾病和呼吸道疾病患者经年龄和性别调整后的12个月精神障碍患病率,并与身体健康的对照者进行比较。
患病率由两项大型流行病学调查计算得出。这些研究调查了住院患者以及来自普通人群的癌症患者(n = 174)、肌肉骨骼疾病患者(n = 1,416)、心血管疾病患者(n = 915)、呼吸道疾病患者(n = 453)以及健康对照者(n = 1,083)。患病率基于慕尼黑综合国际诊断访谈得出,这是一种用于评估精神障碍的标准化访谈。
住院患者(43.7%)和普通人群患者(42.2%)的患病率非常相似。与健康对照者相比,慢性躯体疾病患者患精神障碍的调整优势比(OR)显著升高(OR:2.2)。情绪、焦虑和躯体形式障碍最为常见。躯体指标疾病之间的患病率没有显著差异。每位患者的躯体疾病数量与精神障碍的关联更强。
慢性躯体疾病与精神障碍之间存在密切关系。未来的一项任务是改善慢性躯体疾病患者,特别是患有多种疾病的患者的精神障碍护理。