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神经内科门诊患者的共病精神症状。

Concomitant Psychiatric Symptoms in Neurological Outpatients.

机构信息

School of Communication, Kookmin University, Seoul 02707, Korea.

Department of Neurology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 05355, Korea.

出版信息

Int J Environ Res Public Health. 2019 Mar 9;16(5):860. doi: 10.3390/ijerph16050860.

Abstract

To estimate the prevalence of concomitant psychiatric disorders in neurological outpatients and to assess the value of simple screening questionnaires in the identification of psychiatric symptoms, we analyzed a total of 803 patients who visited neurology clinics with neurological symptoms over a six-month period. Using self-reported questionnaires, we assessed psychiatric symptoms, such as stress (Perceived Stress Scale, PSS), depression (Patient Health Question 9, PHQ9), and anxiety (Generalized Anxiety Disorder 7, GAD7). According to the disease subtypes, we analyzed the psychiatric scales based on gender and age group. The prevalence of psychiatric comorbidities was lowest in patients with cerebrovascular disease (CVD) and highest among patients with cognitive decline and epilepsy. The overall prevalence of psychiatric symptoms markedly decreased with age. This decline was statistically significant for all questionnaires (PSS ≥ 14, for trend = 0.027; PQH9 ≥ 10, for trend = 0.005; GAD7 ≥ 10, for trend = 0.002) and was more pronounced in males. Considering the high incidence of undetected psychiatric comorbidities and their associated burden, proactive psychiatric management should be included in neurological care. Psychiatric questionnaires could also be an effective screening tool for identifying psychiatric symptoms accompanying neurological symptoms.

摘要

为了评估神经科门诊患者共患精神障碍的患病率,并评估简单的筛查问卷在识别精神症状方面的价值,我们分析了在六个月内因神经系统症状就诊于神经科诊所的 803 名患者。我们使用自报问卷评估了精神症状,如压力(感知压力量表,PSS)、抑郁(患者健康问卷 9,PHQ9)和焦虑(广泛性焦虑障碍 7,GAD7)。根据疾病亚型,我们根据性别和年龄组分析了精神科量表。在脑血管疾病(CVD)患者中,精神共病的患病率最低,而在认知能力下降和癫痫患者中患病率最高。精神症状的总体患病率随年龄增长而显著下降。所有问卷(PSS≥14,趋势检验=0.027;PHQ9≥10,趋势检验=0.005;GAD7≥10,趋势检验=0.002)的下降均具有统计学意义,且在男性中更为明显。鉴于未检出的精神共病的高发生率及其相关负担,应在神经科护理中纳入主动的精神管理。精神科问卷也可以是识别伴随神经系统症状的精神症状的有效筛查工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3662/6427503/f93bab315ab2/ijerph-16-00860-g001.jpg

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