Shimada Fumio, Ohira Yoshiyuki, Hirota Yusuke, Ikegami Akiko, Kondo Takeshi, Shikino Kiyoshi, Suzuki Shingo, Noda Kazutaka, Uehara Takanori, Ikusaka Masatomi
Department of General Medicine, Chiba University Hospital, Chiba, Japan.
Int J Gen Med. 2018 Feb 9;11:55-63. doi: 10.2147/IJGM.S130025. eCollection 2018.
Patients who come for a consultation at a general practice clinic as outpatients often suffer from background anxiety and depression. The psychological state of such patients can alleviate naturally; however, there are cases when these symptoms persist. This study investigated the realities and factors behind anxiety/depression becoming prolonged.
Participants were 678 adult patients, who came to Department of General Medicine at Chiba University Hospital within a 1-year period starting from April 2012 and who completed the Hospital Anxiety and Depression Scale (HADS) during their initial consultation. Participants whose Anxiety or Depression scores in the HADS, or both, were 8 points or higher were defined as being within the anxiety/depression group, with all other participants making up the control group. A telephone interview was also conducted with participants. Furthermore, age, sex, the period from the onset of symptoms to the initial consultation at our department, the period from the initial department consultation to the telephone survey, and the existence of mental illness at the final department diagnosis were investigated.
A total of 121 patients (17.8% response rate) agreed to the phone survey. The HADS score during the phone survey showed that the anxiety/depression group had a significantly higher score than the control group. The HADS scores obtained between the initial consultation and telephone survey showed a positive correlation. Logistic regression analysis extracted "age" and the "continuation of the symptoms during the initial consultation" as factors that prolonged anxiety/depression.
Anxiety and depression in general practice outpatients have the possibility of becoming prolonged for an extended period of time. Being aged 65 years or over and showing a continuation of symptoms past the initial consultation are the strongest factors associated with these prolonged conditions. When patients with anxiety and depression exhibit these risk factors, they should be further evaluated for treatment.
在普通诊所进行门诊咨询的患者常常伴有背景性焦虑和抑郁。此类患者的心理状态可能会自然缓解；然而，也有症状持续存在的情况。本研究调查了焦虑/抑郁持续时间延长背后的实际情况及因素。
参与者为678名成年患者，他们在2012年4月开始的1年时间内前往千叶大学医院普通内科就诊，并在初次咨询时完成了医院焦虑抑郁量表（HADS）。HADS中焦虑或抑郁得分，或两者得分均为8分及以上的参与者被定义为焦虑/抑郁组，其他所有参与者构成对照组。还对参与者进行了电话访谈。此外，调查了年龄、性别、从症状出现到在本部门初次咨询的时间、从初次部门咨询到电话调查的时间，以及最终部门诊断时是否存在精神疾病。
共有121名患者（应答率为17.8%）同意接受电话调查。电话调查期间的HADS得分显示，焦虑/抑郁组的得分显著高于对照组。初次咨询和电话调查之间获得的HADS得分呈正相关。逻辑回归分析提取出“年龄”和“初次咨询期间症状持续”作为焦虑/抑郁持续时间延长的因素。
普通门诊患者的焦虑和抑郁有可能长时间持续。65岁及以上以及初次咨询后症状仍持续是与这些持续情况相关的最主要因素。当焦虑和抑郁患者出现这些危险因素时，应进一步评估是否需要治疗。
