Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, the Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Harborview Medical Center, and Northwest Women's Healthcare, Seattle, Washington.
Obstet Gynecol. 2013 Aug;122(2 Pt 1):313-318. doi: 10.1097/AOG.0b013e31829999ee.
To describe the presenting symptoms of women with depression in two obstetrics and gynecology clinics, determine depression diagnosis frequency, and examine factors associated with depression diagnosis.
Data were extracted from charts of women screening positive for depression in a clinical trial testing a collaborative care depression intervention. Bivariate and multivariable analyses examined patient factors associated with the diagnosis of depression by an obstetrician-gynecologist (ob-gyn).
Eleven percent of women with depression presented with a psychologic chief complaint but another 30% mentioned psychologic distress. All others noted physical symptoms only or presented for preventive care. Ob-gyns did not identify 60% of women with a depression diagnosis. Depression severity was similar in women who were or were not diagnosed by their ob-gyns. Bivariate analyses showed four factors significantly associated with depression diagnosis: reporting a psychologic symptom as the chief complaint or associated symptom (72% compared with 18.6%, P<.001), younger age (35.5 years compared with 40.8 years, P<.005), being within 12 months postpartum (13.9% compared with 2.8%, P<.005), and a primary care-oriented visit (72% compared with 30%, P<.001). Multivariable analysis showed that reporting a psychologic symptom (adjusted odds ratio [OR] 8.90, 95% confidence interval [CI] 4.15-19.10, P<.001), a primary care oriented visit (adjusted OR 2.46, 95% CI 1.14-5.29, P=.03), and each year of increasing age (adjusted OR 0.96, 95% CI 0.93-0.96, P=.02) were significantly associated with a depression diagnosis.
The majority of women with depression presented with physical symptoms; most women with depression were not diagnosed by their ob-gyn, and depression severity was similar in those diagnosed and those not diagnosed.
III.
描述两家妇产科诊所中患有抑郁症的女性的就诊症状，确定抑郁症诊断的频率，并研究与抑郁症诊断相关的因素。
从一项协作式护理抑郁症干预临床试验中对抑郁症进行筛查的女性图表中提取数据。使用单变量和多变量分析，检查与妇产科医生（ob-gyn）诊断抑郁症相关的患者因素。
11%的抑郁症女性以心理主诉就诊，但另有 30%的女性提到心理困扰。其他所有人仅报告了身体症状或就诊于预防保健。ob-gyn 未识别出 60%的抑郁症患者。抑郁症严重程度在 ob-gyn 诊断和未诊断的女性中相似。单变量分析显示，四个因素与抑郁症诊断显著相关：将心理症状报告为主要或相关症状（72%与 18.6%，P<.001）、年龄较小（35.5 岁与 40.8 岁，P<.005）、产后 12 个月内（13.9%与 2.8%，P<.005）和以初级保健为导向的就诊（72%与 30%，P<.001）。多变量分析显示，报告心理症状（调整后比值比 [OR] 8.90，95%置信区间 [CI] 4.15-19.10，P<.001）、以初级保健为导向的就诊（调整后 OR 2.46，95% CI 1.14-5.29，P=.03）和每年增加一岁（调整后 OR 0.96，95% CI 0.93-0.96，P=.02）与抑郁症诊断显著相关。
大多数患有抑郁症的女性表现出身体症状；大多数患有抑郁症的女性未被 ob-gyn 诊断，且诊断和未诊断的女性抑郁症严重程度相似。
III。
