Cardoso Graça, Alexandre Joana, Rosa Alda
Serviço de Psiquiatria, Hospital Fernando Fonseca, 2720-276 Amadora, Portugal.
Clin Pract Epidemiol Ment Health. 2010 Jul 8;6:47-52. doi: 10.2174/1745017901006010047.
To assess depression, anxiety, and alcohol abuse in a Gastroenterology ICU, and the level of its detection by the staff.
All patients consecutively admitted to the ICU during a six-month period, 18 or above, and staying ≥ 24 hours, were assessed with the Hospital Anxiety and Depression Scale (HADS) and the CAGE. Doctors and nurses assessed the type and severity of patients' morbidity. Data were analyzed with Student's t-test, Pearson's and Spearman's correlations for ordinal variables, chi-square for nominal variables, and multiple logistic regression.
The 65 patients assessed had a mean age of 57, and were predominantly male (58.5%), married (72.3%), and retired (53.8%); 27.7% had a psychiatric history, 24.6% were on psychotropic drugs, and 32.3% had an alcohol intake above standards. Anxiety and depression HADS scores ≥ 8 were present in 29.2% and 35.4% of the patients, respectively; 20%, mainly men, scored positive on the CAGE. Women had significantly higher anxiety scores (=.012) than men but did not differ in depression. A psychiatric history was significantly associated with higher anxiety (p<.001) and depression (p=.007) scores, as well as being on psychotropic drugs regularly (p<.001; p=.03, respectively). Doctors diagnosed somatic illness in 48.8%, and somatic illness with psychiatric co-morbidity in 51%; for nurses the rates were, respectively, 41.5% and 58.6%. Doctors' and nurses' detection of psychiatric disorders were significantly associated with the HADS anxiety scores (p=.013; p=.001, respectively), and doctor's detection with depression (p=.046) scores. There were no significant associations between nurses' detection of psychiatric disorders and depression, and between both professional groups detection and alcohol abuse.
High prevalence of depression, anxiety, and alcohol abuse in Gastroenterology ICU was confirmed. However, the level of detection by the staff was low and mainly when anxiety symptoms were present.
评估胃肠病重症监护病房（Gastroenterology ICU）患者的抑郁、焦虑及酒精滥用情况，以及医护人员对这些情况的识别水平。
对连续6个月入住该重症监护病房、年龄18岁及以上且住院时间≥24小时的所有患者，采用医院焦虑抑郁量表（HADS）和CAGE问卷进行评估。医生和护士对患者疾病的类型和严重程度进行评估。数据采用学生t检验、针对有序变量的Pearson和Spearman相关性分析、针对名义变量的卡方检验以及多元逻辑回归进行分析。
接受评估的65例患者平均年龄为57岁，主要为男性（58.5%）、已婚（72.3%）、退休人员（53.8%）；27.7%有精神病史，24.6%正在服用精神类药物，32.3%饮酒量超标。分别有29.2%和35.4%的患者焦虑和抑郁的HADS评分≥8；20%的患者CAGE问卷呈阳性，主要为男性。女性的焦虑评分显著高于男性（p = 0.012），但抑郁评分无差异。精神病史与较高的焦虑（p < 0.001）和抑郁（p = 0.007）评分显著相关，同时也与定期服用精神类药物显著相关（分别为p < 0.001；p = 0.03）。医生诊断躯体疾病的比例为48.8%，诊断躯体疾病合并精神疾病的比例为51%；护士的诊断比例分别为41.5%和58.6%。医生和护士对精神障碍的识别与HADS焦虑评分显著相关（分别为p = 0.013；p = 0.001），医生对抑郁的识别与抑郁评分相关（p = 0.046）。护士对精神障碍的识别与抑郁之间、两个专业组对精神障碍的识别与酒精滥用之间均无显著关联。
胃肠病重症监护病房中抑郁、焦虑及酒精滥用的发生率较高。然而，医护人员的识别水平较低，且主要是在存在焦虑症状时。
