失眠及抑郁障碍522例主诉失眠患者临床特点及HAMD分析.docVIP

失眠及抑郁障碍522例主诉失眠患者临床特点及HAMD分析作者单位：710300 西安市户县甘亭镇卫生院 通讯作者：王希林 【摘要】 目的 了解精神科门诊首诊，主诉失眠患者的临床特点，探讨失眠与抑郁障碍之间的关系，并就患者就诊、诊断情况及疾病识别影响因素进行分析。方法 对522例主诉失眠患者填写症状问卷，进行HAMD、SAS评分，对存在抑郁患者用ICD-10进行诊断，并记录患者选择就诊医院、方式、诊断及疾病识别情况和相关表格。结果 （1）522例主诉失眠患者中HAMD评分存在抑郁患者473例，用ICD-10诊断得出抑郁障碍患者436例。（2）HAMD总分平均22.34分,各因子分≥2分的频率发现项目中以1、10、4、6、5、11、12项为突出表现。（3）436抑郁障碍患者中除失眠外的其他主诉依次为:胃肠症状、头晕头痛、心烦不安、全身乏力、心慌气短等。（4）患者病初在综合医院就诊率高，医生识别和患者自我识别率低，部分患者的抑郁情绪是由失眠所致。结论 主诉失眠患者ICO-10诊断多为抑郁障碍患者，失眠与抑郁障碍之间关系密切，患者除情绪症状外表现有多种形式的“失眠”和躯体症状。患者起病初多反复就诊于综合医院，且医生识别率低。抑郁障碍知识普及率、知晓率低和躯体症状是影响识别的主要因素。 【关键词】 失眠； 抑郁障碍； 综合医院； 临床特点； 影响因素 Insomnia and depressive disorder: 522 patients complained of insomnia, clinical characteristics and analysis of HAMD WANG Xi-lin，LI Sheng-hui.Xi’an huxian ganting Hospital，huxian 710300，China 【Abstract】 Objective To understand the psychiatric outpatient clinic complaining of insomnia in patients with first clinical features of insomnia and the relationship between depression and treatment for patients, diagnose conditions and diseases, identification of factors were analyzed.Methods 522 patients complained of insomnia symptoms in patients with completed questionnaires, the HAMD, SAS score, the existence of depression in patients with ICD-10 diagnosis and patients to choose hospital records, methods, diagnosis and disease identification and related forms.Results 1.522 cases of patients complained of insomnia in patients with HAMD scores 473 cases of depression, with ICD-10 diagnosis of depressive disorders in 436 patients drawn.2.HAMD Total average 22.34 points, each factor the frequency of ≥ 2 points to 1,10,4,6,5,11,12 items found in the project to highlight the performance. 3.436, in addition to patients with depression complain of insomnia other than as follows: gastrointestinal symptoms, dizziness, headache, upset, anxiety, malaise, palpitation and shortness of breath and so on. 4. in patients with early disease rate in the general hospital, doctors and patients identify self-id