Abstract
Objective To examine the patterns of physical symptoms and diagnoses among outpatients in general hospitals and their relationship with depression or anxiety disorders. Methods In this cross - sectional survey, 8487 subjects were screened by Hospital Anxiety and Depression Scale ( HADS ), and their physical symptoms and diagnoses were all recorded during routine clinical visit. Furthermore, 2456 subjects with an HADS score ≥8 evaluated with Mini International Neuropsychaitric Interview ( MINK. 0. 0 ) by psychiatrists. Data of 6771 subjects were included in the comparative statistical analysis. Results The risk of depression or anxiety disorder significantly increased with the increase of physical symptoms ( ORdepression =1.51 ~ 2. 11, ORanxiety = 1. 75 ~ 1. 87, ORdepression/anxiety, = 1. 57 ~ 2. 03 , P < 0. 001 ). Outpatients with depression or anxiety disorders were more likely to complain fatigue ( ORdepression = 1. 98 , ORanxiety = 1. 67 , ORdepression/anxiety= 1. 88 , P = 0. 000 ~ 0. 002 ), weakness ( ORdepression =2.18, ORanxiety =2.14, ORdepression/anxiety, =1.95, P = 0.000 ~ 0.001), insomnia ( ORdepression=2.85, ORanxiety = 2.88, ORdepression/anxiety =2.95, P < 0.001 ), slow thinking ( ORdepression =2.36, P = 0.037 ), loss of appetite ( ORdepression/anxiety =1.40, P = 0.043 ), instable mood (ORdepression =3.42, ORanxiety =3.33, ORdepression/anxiety =2.10, P≤S 0.001 ), and anxiety ( ORdepression =5. 10, ORanxiety =5.30, ORdepression/anxiety. =5.49, P≤0.001 ) than those without, with statistically significance. The risk of depression or anxiety disorder was significantly higher in outpatients with coexisting physical symptoms ( fatigue, weakness, or insomnia ) and mental symptoms ( instable mood or anxiety ) than in those with none of the symptoms ( ORdepression =2. 22 ~5.67, ORanxiety = 2. 02 -4.35,ORdepression/anxiety = 2. 13 ~4.15, P < 0.001 ). Patients with depression or anxiety wTere more frequent to have physical diagnosis of cardiovascular neurosis ( ORdepression = 3. 81, ORanxiety = 2.97, ORdepression/anxiety = 2. 82, P =0.001 -0.025), gastro - esophageal reflux disease ( ORdepression = 1.44,ORanxiety, = 1. 51, ORdepression/anxiety =1.46, PssO. 001 ), peripheral neuralgia ( ORdepression =1.71, ORanxiety, =1.99, ORdepression/anxiety =1.73, P < 0.001), gastritis ( ORdepression =1.48, ORdepression/anxiety = 1. 33, P = 0. 004 ~ 0.021), pelvic inflammatory disease ( ORdepression = 2. 17, ORdepression/anxiety. = 1. 82, P = 0. 005 ~ 0. 027 ) or cardiovascular unknown origin ( ORanxiety = 1. 82, P = 0. 003 ) than those without, while diagnosis of hypertension ( ORdepression =0.72, ORanxiety =0.58, ORdepression/anxiety =0.65, P =0.000 ~ 0.013), coronary heart disease ( ORanxiety =0.48, P =0.021 ), and vulva vaginitis ( ORdepression =0.59, ORanxiety =0.63, ORdepression/anxiety = 0. 64, P = 0. 000 ~ 0. 005 ) were significantly less frequent. Conclusion Outpatients with depression/anxiety disorders have more complaints, which usually show certain features. They tend to have multiple symptoms and are often coexist with physical and mental symptoms such as fatigue, weakness, insomnia, instable mood, or anxiety, which may serve as an a-lert for depression or anxiety disorder.关键词
抑郁/焦虑/体征和症状/诊断/躯体主诉Key words
Depression/ Anxiety/ Signs and symptoms/ Diagnosis/ Physical complains分类
医药卫生
