炎症性肠病患者焦虑、抑郁水平及其影响因素
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摘要
目的:探讨炎症性肠病患者焦虑、抑郁水平及其影响因素。方法:选择同济大学附属第十人民医院胃肠内科2017年1月-2018年3月收治的130例炎症性肠病患者,同期选择84例门诊体检健康者。比较炎症性肠病组和对照组医院焦虑抑郁量表(HAD)情绪测定评分,分析炎症性肠病患者焦虑、抑郁水平影响的单因素及多因素。结果:炎症性肠病组焦虑发生率及抑郁发生率、焦虑评分及抑郁评分均高于对照组,比较有统计学差异(χ~2=35.462、43.354,t=30.112、31.481;P<0.05)。单因素分析显示,炎症性肠病患者焦虑、抑郁水平和性别、年龄、文化程度、病情程度、婚姻状况、付费方式、负性生活事件有关(χ~2=17.621,27.073,21.217,28.130,8.458,15.265,33.728,51.276,33.568,35.939,9.259,10.211,26.805,38.097;P<0.05),和疾病类型无关(P>0.05)。多因素Logistic回归分析显示,年龄、文化程度、病情程度及负性生活事件为焦虑及抑郁发生的危险因素,性别及付费方式不是焦虑及抑郁发生的危险因素。结论:炎症性肠病患者伴一定程度的焦虑及抑郁情绪,其发生和多种因素相关,临床应加强对此类因素的重视程度,以采用相应的干预措施,改善患者心理状态。
Objective:To study the levels of anxiety and depression levels in patients with inflammatory bowel disease and it's influencing factors.Methods:A total of 130 patients with inflammatory bowel disease who treated from gastroenterology,The Tenth People's Hospital Affiliated to Tongji University January 2017 to March 2018,During the same period,84 outpatients were selected for physical examination.The scores of the hospital anxiety and depression scale(HAD)in the inflammatory bowel disease group and the control group was compared,the single and multiple factors influencing anxiety and depression levels in patients with inflammatory bowel disease were analyzed.Results:The incidence rate of anxiety,depression,anxiety score and depression score of the inflammatory bowel disease group were higher than those of the control group(χ~2=35.462,43.354,t=30.112,31.481;P<0.05).Univariate analysis showed that the level of anxiety and depression in patients with inflammatory bowel disease was related to gender,age,education level,degree of illness,marital status,payment methods,and negative life events(χ~2=17.621,27.073,21.217,28.130,8.458,15.265,33.728,51.276,33.568,35.939,9.259,10.211,26.805,38.097;P<0.05),but not to the type of disease(P>0.05).Multivariate Logistic regression analysis showed that age,education level,severity of illness and negative life events were risk factors for anxiety and depression.Gender and payment methods were not risk factors for anxiety and depression.Conclusion:Inflammatory bowel disease is associated with a certain degree of anxiety and depression,its occurrence is related to many factors,the degree of emphasis on such factors should be strengthened clinically,to adopt appropriate interventions,improve patient's mental state.
Objective:To study the levels of anxiety and depression levels in patients with inflammatory bowel disease and it's influencing factors.Methods:A total of 130 patients with inflammatory bowel disease who treated from gastroenterology,The Tenth People's Hospital Affiliated to Tongji University January 2017 to March 2018,During the same period,84 outpatients were selected for physical examination.The scores of the hospital anxiety and depression scale(HAD)in the inflammatory bowel disease group and the control group was compared,the single and multiple factors influencing anxiety and depression levels in patients with inflammatory bowel disease were analyzed.Results:The incidence rate of anxiety,depression,anxiety score and depression score of the inflammatory bowel disease group were higher than those of the control group(χ~2=35.462,43.354,t=30.112,31.481;P<0.05).Univariate analysis showed that the level of anxiety and depression in patients with inflammatory bowel disease was related to gender,age,education level,degree of illness,marital status,payment methods,and negative life events(χ~2=17.621,27.073,21.217,28.130,8.458,15.265,33.728,51.276,33.568,35.939,9.259,10.211,26.805,38.097;P<0.05),but not to the type of disease(P>0.05).Multivariate Logistic regression analysis showed that age,education level,severity of illness and negative life events were risk factors for anxiety and depression.Gender and payment methods were not risk factors for anxiety and depression.Conclusion:Inflammatory bowel disease is associated with a certain degree of anxiety and depression,its occurrence is related to many factors,the degree of emphasis on such factors should be strengthened clinically,to adopt appropriate interventions,improve patient's mental state.
引文
[1]张茂琛,洪理文,张天宇,等.克罗恩病患者健康状况、疾病认知、应对方式与心理状况之间的关系[J].内科理论与实践,2016,11(5):296-300
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[10]Park D I,Hisamatsu T,Chen M,et al.Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment.Part 2:Management[J].J Gastroenterol Hepatol,2018,33(1):30-36
[11]Taft T H,Ballou S,Bedell A,et al.Psychological considerations and interventions in inflammatory bowel disease patient care[J].Gastroenterol Clin North Am,2017,46(4):847-858
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[13]王敬斋,张树荣.Zung焦虑抑郁自评量表对消化内科门诊患者焦虑抑郁的测评[J].临床消化病杂志,2016,28(3):150-153
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[15]陶思玉,金婧.心理行为干预对溃疡性结肠炎焦虑抑郁患者的影响分析[J].重庆医学,2016,45(32):4596-4599
[16]Claar R L,Tilburg M A L V,Abdullah B,et al.Psychological distress and quality of life in pediatric crohn disease:Impact of pain and disease state[J].J Pediatr Gastroenterol Nutr,2017,65(4):420-424
[17]张淑艳,刘炯.心理因素与炎症性肠病的研究进展[J].东南国防医药,2017,19(3):276-279
[18]李雪娇,彭南海,黄迎春,等.炎症性肠病病人焦虑、抑郁状况及与生活质量的相关性研究[J].护理研究,2015,29(27):3364-3367
[19]王丽媛,朱伟宁,史玲.溃疡性结肠炎合并焦虑和/或抑郁患者诊疗进展及临床经验总结[J].中国医药导报,2017,14(36):129-132
[20]魏汉维,彭国萍,姚昌伟.炎症性肠病患者心理应激评估及其影响因素[J].职业与健康,2016,32(4):519-521
[21]罗涵青,钱家鸣.炎症性肠病的心理应激评估[J].中华内科杂志,2015,54(2):164-167
[22]胡义亭,张建,贾桂丛,等.炎症性肠病患者焦虑、抑郁状态分析及其与生活质量的关系[J].中国医药导报,2017,14(28):57-59+68
[23]朱秀丽,王巧民,吴正祥,等.炎症性肠病患者精神心理与临床症状及生活质量关系的研究[J].胃肠病学和肝病学杂志,2017,26(10):1159-1161
[2]Engel T,Ungar B,Ben-Haim G,et al.Re-phrasing the question:A simple tool for evaluation of adherence to therapy in patients withinflammatory bowel disease[J].United European Gastroenterol J,2017,5(6):880-886
[3]李超,崔立红,王晓辉,等.肠易激综合征患者焦虑、抑郁状况调查[J].解放军医药杂志,2014,26(2):25-26
[4]杜佩凤,陈继彬.肠易激综合征重叠功能性消化不良患者与心理因素关系及疗效分析[J].中国预防医学杂志,2016,17(6):479-480
[5]林德荣,李健,王宏艳,等.炎症性肠病与精神心理因素的关系[J].实用临床医药杂志,2017,21(11):232-234
[6]Chan W,Shim H H,Lim M S,et al.Symptoms of anxiety and depression are independently associated with inflammatory bowel disease-related disability[J].Dig Liver Dis,2017,49(12):1314-1319
[7]中华医学会消化病学分会炎症性肠病协作组.中国炎症性肠病诊断治疗规范的共识意见[J].中华内科杂志,2008,47(1):139-145
[8]Ergün D,Ergün R,Ergan B,et al.Occupational risk factors and the relationship of smoking with anxiety and depression[J].Turk Thorac J,2018,19(2):77-83
[9]Conley S,Proctor D D,Jeon S,et al.Symptom clusters in adults with inflammatory bowel disease[J].Res Nurs Health,2017,40(5):424-434
[10]Park D I,Hisamatsu T,Chen M,et al.Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment.Part 2:Management[J].J Gastroenterol Hepatol,2018,33(1):30-36
[11]Taft T H,Ballou S,Bedell A,et al.Psychological considerations and interventions in inflammatory bowel disease patient care[J].Gastroenterol Clin North Am,2017,46(4):847-858
[12]Limketkai B N,Wolf A,Parian A M.Nutritional interventions in the patient with inflammatory bowel disease[J].Gastroenterol Clin North Am,2017,47(1):155-177
[13]王敬斋,张树荣.Zung焦虑抑郁自评量表对消化内科门诊患者焦虑抑郁的测评[J].临床消化病杂志,2016,28(3):150-153
[14]Sirois F M,Hirsch J K.A longitudinal study of the profiles of psychological thriving,resilience,and loss in people with inflammatory bowel disease[J].Br J Health Psychol,2017,22(4):920-939
[15]陶思玉,金婧.心理行为干预对溃疡性结肠炎焦虑抑郁患者的影响分析[J].重庆医学,2016,45(32):4596-4599
[16]Claar R L,Tilburg M A L V,Abdullah B,et al.Psychological distress and quality of life in pediatric crohn disease:Impact of pain and disease state[J].J Pediatr Gastroenterol Nutr,2017,65(4):420-424
[17]张淑艳,刘炯.心理因素与炎症性肠病的研究进展[J].东南国防医药,2017,19(3):276-279
[18]李雪娇,彭南海,黄迎春,等.炎症性肠病病人焦虑、抑郁状况及与生活质量的相关性研究[J].护理研究,2015,29(27):3364-3367
[19]王丽媛,朱伟宁,史玲.溃疡性结肠炎合并焦虑和/或抑郁患者诊疗进展及临床经验总结[J].中国医药导报,2017,14(36):129-132
[20]魏汉维,彭国萍,姚昌伟.炎症性肠病患者心理应激评估及其影响因素[J].职业与健康,2016,32(4):519-521
[21]罗涵青,钱家鸣.炎症性肠病的心理应激评估[J].中华内科杂志,2015,54(2):164-167
[22]胡义亭,张建,贾桂丛,等.炎症性肠病患者焦虑、抑郁状态分析及其与生活质量的关系[J].中国医药导报,2017,14(28):57-59+68
[23]朱秀丽,王巧民,吴正祥,等.炎症性肠病患者精神心理与临床症状及生活质量关系的研究[J].胃肠病学和肝病学杂志,2017,26(10):1159-1161