卡塔尔初级保健中焦虑和抑郁障碍的患病率、症状模式和共病情况。

Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in Qatar.

机构信息

Department of Medical Statistics and Epidemiology, Hamad General Hospital, Hamad Medical Corporation and Weill Cornell Medical College, PO Box 3050, Doha, Qatar.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2012 Mar;47(3):439-46. doi: 10.1007/s00127-011-0349-9. Epub 2011 Feb 4.

Abstract

AIM

The aim of this study was to assess the prevalence of anxiety and depressive disorders in a Qatari population who attend the primary health care settings and examine their symptom patterns and comorbidity.

DESIGN

This is a prospective cross-sectional study conducted during the period from July 2009 to December 2009.

SETTING

Primary Health Care Center and the Supreme Council of Health in the State of Qatar.

SUBJECTS

A total of 2,080 Qatari subjects aged 18-65 years were approached and 1,660 (79.8%) patients participated in this study.

METHODS

The study was based on a face-to-face interview with a designed diagnostic screening questionnaire, which consisted of 14 items for anxiety and depression disorders. Socio-demographic characteristics, comorbidity factors, and medical history of patients were collected. The Hospital Anxiety and Depression Rating Scale (HADS), which consisted of seven items for anxiety (HADS-A) and seven for depression (HADS-D), was used. The items are scored on a 4-point scale from zero (not present) to 3 (considerable). The HADS-A had an optimal cut-off ≥ 8 (sensitivity 0.87 and specificity 0.78), and the HADS-D had an optimal cut-off ≥ 8 (sensitivity 0.82 and specificity 0.86). The HADS scales generally used the cut-off score ≥ 8 to identify respondents with the possible presence of anxiety or depression.

RESULTS

Of the studied Qatari subjects, 46.2% were males and 53.8% were females. The mean HADS-A anxiety symptom scores were 4.1 ± 3.6 for males and 4.9 ± 3.7 for females (p = 0.048) and with a prevalence of 18.7% among males and 24.6% among females (p = 0.017). The mean HADS-D depressive symptom scores were 8.0 ± 6.3 for males and 10.8 ± 7.5 for females (p = 0.041) and with a prevalence of 26.6% among males and 30.1% among females (p = 0.219). Qatari women were at higher risk for depression (53.1 vs. 46.9%) and anxiety disorder (56.7 vs. 43.3%) as compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 18-34 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001), and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%). Diabetes mellitus (23.4 vs. 19.2%), hypertension (25.7 vs. 25.0%), headache and migraine (21.6 vs. 25.4%), and low back pain (22.2 vs. 28.6%) were the frequent comorbidity conditions in both anxiety and depressive disorders, respectively, in the studied subjects.

CONCLUSION

The findings of this study revealed that depression was more prevalent in the Qatari population than anxiety disorders. Women were likelier than men to have depression and anxiety disorders. The high-risk groups of depression and anxiety disorders were female gender, being married, middle aged, and highly educated.

摘要

目的

本研究旨在评估在卡塔尔的初级保健机构就诊的人群中焦虑和抑郁障碍的患病率,并研究其症状模式和共病情况。

设计

这是一项在 2009 年 7 月至 2009 年 12 月期间进行的前瞻性横断面研究。

地点

卡塔尔初级保健中心和卡塔尔最高卫生委员会。

对象

共纳入 2080 名年龄在 18-65 岁之间的卡塔尔患者,其中 1660 名(79.8%)患者参与了本研究。

方法

本研究基于面对面访谈和设计的诊断筛查问卷进行,问卷包括焦虑和抑郁障碍的 14 个项目。收集患者的社会人口统计学特征、共病因素和病史。采用医院焦虑抑郁量表(HADS),包括焦虑的 7 个项目(HADS-A)和抑郁的 7 个项目(HADS-D)。每个项目的评分范围为 0(不存在)至 3(明显)。HADS-A 的最佳截断值≥8(敏感性为 0.87,特异性为 0.78),HADS-D 的最佳截断值≥8(敏感性为 0.82,特异性为 0.86)。通常使用 HADS 量表的截断值≥8 来识别可能存在焦虑或抑郁的受访者。

结果

在所研究的卡塔尔人群中,46.2%为男性,53.8%为女性。男性的 HADS-A 焦虑症状平均得分为 4.1±3.6,女性为 4.9±3.7(p=0.048),男性的患病率为 18.7%,女性为 24.6%(p=0.017)。男性的 HADS-D 抑郁症状平均得分为 8.0±6.3,女性为 10.8±7.5(p=0.041),男性的患病率为 26.6%,女性为 30.1%(p=0.219)。与男性相比,卡塔尔女性患抑郁(53.1%比 46.9%)和焦虑障碍(56.7%比 43.3%)的风险更高。超过一半的焦虑症(56.7%)和抑郁症(53.1%)患者是卡塔尔女性,年龄在 18-34 岁的患者更为常见。在抑郁方面,男性和女性在年龄组(p=0.004)、婚姻状况(p=0.04)、职业(p<0.001)和家庭收入(p=0.002)方面存在显著差异。焦虑症患者最常见的症状是紧张(68.4%),而抑郁症患者最常见的症状是睡眠困难(59.4%)。糖尿病(23.4%比 19.2%)、高血压(25.7%比 25.0%)、头痛和偏头痛(21.6%比 25.4%)和腰痛(22.2%比 28.6%)是研究对象中焦虑和抑郁障碍的常见共病情况。

结论

本研究结果表明,卡塔尔人群中抑郁的患病率高于焦虑障碍。女性比男性更容易患有抑郁和焦虑障碍。抑郁和焦虑障碍的高危人群是女性、已婚、中年和高学历。

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