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山东省抑郁障碍患者生命质量及危险因素

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目的:研究山东省抑郁障碍患者生命质量特点及相关危险因素。方法:对2015年山东省精神障碍流行病调查中使用精神障碍诊断与统计手册第4版(DSM-Ⅳ)和《DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查研究版》(SCID-I/P)诊断出的抑郁障碍患者832例和抑郁障碍发病高危人群807例、低危人群819例3组人群,于2020年使用SCID-I/P进行再诊断,并用一般健康问卷(GHQ-12)、简易生命质量问卷、匹兹堡睡眠质量指数量表(PSQI)、儿童期创伤问卷(CTQ)、社会支持评定量表(SSRS)、整体疼痛评估量表(GPS)、蒙特利尔认知评估量表(MoCA)、简易应对方式问卷(SCSQ)进行评估,比较抑郁障碍患者生命质量变化并构建其危险因素模型。结果:抑郁障碍患者基线和5年复评的简易生命质量问卷得分均低于高危组和低危组,抑郁障碍缓解组基线和5年复评的简易生命质量问卷得分均高于未缓解组,高危组和低危组中2020年新发病者基线和5年复评的简易生命质量问卷得分均低于未发病者(均P<0。001)。基线的抑郁障碍诊断、PSQI得分均负向预测5年复评的简易生命质量问卷得分(β=-0。06、-0。15),基线的应对方式倾向正向预测5年复评的简易生命质量问卷得分(β=0。06);基线的简易生命质量问卷得分负向预测5年复评的抑郁障碍诊断、GHQ-12得分及PSQI得分(β=-0。11、-0。17、-0。09),基线的简易生命质量问卷得分正向预测5年复评的应对方式倾向(β=0。13)。5年复评的抑郁障碍诊断、GHQ-12得分、PSQI得分、应对方式倾向、SSRS得分、CTQ得分、GPS得分以及基线的生命质量问卷得分均对5年复评的生命质量问卷得分通过直接或间接途径进行影响。结论:抑郁障碍患者生命质量低于一般人群。抑郁障碍诊断、睡眠质量、心理健康、疼痛、社会支持、儿童期创伤、应对方式等是生命质量的直接和间接危险因素。
Quality of life and risk factors of patients with depression in Shandong Province
Objective:To study the life characteristics and related risk factors of patients with depression in Shandong Province.Methods:Based on the 2015 mental epidemiological survey database in Shandong Province,a total of 832 patients with depression,807 high-risk individuals with depression,and 819 low-risk individuals were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)and the Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders,Research Version(SCID-I/P).In 2020,SCID-I/P was used for re diagnosis,and the General Health Questionnaire(GHQ-12),Simple Quality of Life question-naire,Pittsburgh sleep quality index(PSQI),Childhood Trauma Questionnaire(CTQ),Social Support Rating Scale(SSRS),Global Pain Scale(GPS),Montreal Cognitive Assessment(MoCA),Simplified Coping Style Question-naire(SCSQ)were used for evaluation.Compare changes in the quality of life of depression patients and construct a risk factor model.Results:Patients with depression had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in the high-and low-risk groups,those in remission of depression had higher scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in non-re-mission,and those with new-onset disorder in the high-and low-risk groups had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those with no-onset disorder(Ps<0.001).Depres-sion diagnosis and PSQI scale scores at baseline negatively predicted at retest after 5 years(β=-0.06,-0.15),while coping style tendencies at baseline positively predicted(β=0.06).The simple quality of life questionnaire at baseline negatively predicted depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,and PSQI scale scores at retest after 5 years(β=-0.11,-0.17,-0.09),while the simple quality of life question-naire at baseline positively predicted coping style tendencies at retest after 5 years(β=0.13).Depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,PSQI scale scores at retest after 5 years,coping style tendencies at retest after 5 years,SSRS scale scores,CTQ scale scores,GPS scale scores,and the simple quality of life questionnaire at baseline all influenced the simple quality of life questionnaire at retest after 5 years through ei-ther direct or indirect pathways.Conclusion:It suggest that the quality of life is lower in patients with depression than in the general population.Depression diagnosis,sleep,mental health,pain,social support,childhood trauma and coping are direct and indirect risk factors affecting life.

depressionquality of liferisk factors

刘俊廷、程小菁、张敬悬、王汝展、李晓靖、王倩、王程辉、丁昊、钱丽菊、万晓娜、田雪、侯宗银、刘风杰、刘进东

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济宁医学院精神卫生学院,山东济宁 272067

山东省精神卫生中心,济南 250014

潍坊市精神卫生中心,山东潍坊 261072

淄博市精神卫生中心,山东淄博 255199

山东省戴庄医院,山东济宁 272075

青岛市精神卫生中心,山东青岛 266034

临沂市精神卫生中心,山东临沂 276005

枣庄市精神卫生中心,山东枣庄 277103

聊城市第四人民医院,山东聊城 252002

菏泽市第三人民医院,山东菏泽 274006

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抑郁障碍 生命质量 危险因素

山东省中西医结合专病防治项目

YXH2019ZXY006

2024

中国心理卫生杂志
中国心理卫生协会

中国心理卫生杂志

CSTPCDCHSSCD北大核心
影响因子:2.088
ISSN:1000-6729
年,卷(期):2024.38(6)