文章摘要
老年慢性病共病患者抑郁 焦虑状况及影响因素
Analysis of depression anxiety and influencing factors in elderly patients with chronic comorbidity
投稿时间：2022-07-14  
DOI：10.3969/j.issn.1000-0399.2023.03.003
中文关键词: 老年  慢性病共病  焦虑  抑郁  影响因素
英文关键词: Elderly  Chronic comorbidity  Anxiety  Depression  Influencing factors
基金项目:首都全科医学研究专项（编号：21QK07），首都医科大学全科医学第一临床学系全科医学研究专项课题（编号：2022QK05）
作者单位E-mail
张强 100053 北京西城 首都医科大学宣武医院急诊科  
王长远 100053 北京西城 首都医科大学宣武医院急诊科 wangchangyuan73@163.com 
李一凡 102600 北京大兴 北京市大兴区林校街道社区卫生服务中心  
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中文摘要:
      目的 研究老年慢性病共病患者焦虑、抑郁的发生率及其影响因素，为临床早期干预提供依据。方法 收集2021年6月到2022年6月在北京市大兴区林校社区卫生中心就诊老年慢性病共病患者504例，采用问卷调查方法记录患者的年龄、性别、文化程度、家庭可支配收入、居住方式、慢性病种类、慢性病支出情况等一般资料。应用Zung焦虑自评量表（SAS）和抑郁自评量表（SDS）对504例老年慢性病患者进行评分，分析不同性别、可支配收入、文化程度、慢性病数量和居住方式等患者SAS和SDS评分的差别，采用多因素logistic回归分析不同因素对老年慢性病共病患者焦虑、抑郁状态的影响。结果 老年慢性病共病患者的焦虑发生率为49.80%，抑郁发生率为51.58%，同时伴有焦虑抑郁状态的发生率46.62%。可支配收入、文化程度、慢性病种类和居住方式不同的老年慢性病患者SAS和SDS评分差异有统计学意义（P均<0.01）。logistic回归分析显示，家庭可支配收入高（OR=0.457，95% CI：0.331～0.630）是老年慢性病共病患者焦虑的保护性因素，独居（OR=1.799，95% CI：1.494～2.166）和慢性病种类多（OR=2.086，95% CI：1.606～2.711）是焦虑状态的独立危险因素。文化程度高（OR=0.665，95% CI：0.508～0.872）和家庭可支配收入高（OR=0.466，95% CI：0.337～0.644）是老年慢性病共病患者抑郁状态的保护性因素，独居（OR=1.971，95% CI：1.628～2.385）和慢性病种类多（OR=1.795，95% CI：1.382～2.332）是抑郁状态的独立危险因素（P<0.05）。结论 老年慢性病共病患者的抑郁、焦虑状态的发生率高，独居和合并慢病种类多是焦虑抑郁状态的独立危险因素，应加强心理干预和社会支持。
英文摘要:
      Objective To study the incidence of anxiety and depression and influencing factors in elderly patients with chronic comorbidity, so as to provide evidence for clinical early intervention. Methods A total of 504 elderly patients with chronic comorbidity were collected from June 2021 to June 2022 at the Linxiao Community Health Center in Daxing District, Beijing. The general information of patients, such as age, sex, education level, disposable income, living style, type of chronic comorbidity, and expenditure on chronic comorbidity were recorded by questionnaires. Altogether 504 elderly patients with chronic comorbidity were scored with zung Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS). The differences in SAS and SDS scores of different genders, disposable income, educational level, number of chronic diseases and living style were analyzed. Multivariate logistic regression was used to analyze the effects of different factors on anxiety and depression of elderly patients with chronic comorbidity. Results The incidence of anxiety and depression was 49.80% and 51.58% in elderly patients with chronic comorbidity, and the incidence of anxiety and depression was 46.62% together. The SAS and SDS scores showed significant differences in elderly patients with chronic comorbidity with different disposable income, different education levels, different number of chronic diseases and different living styles (all P<0.01). Logistic regression analysis showed that high household disposable income (OR=0.457, 95% CI:0.331~0.630) was a protective factor for anxiety of elderly patients with chronic comorbidity. Living alone (OR=1.799, 95%CI:1.494~2.166) and having various chronic diseases (OR=2.086, 95%CI:1.606~2.711) were independent risk factors for anxiety. High education level (OR=0.665, 95%CI:0.508~0.872) and high household disposable income (OR=0.466, 95%CI:0.337~0.644) were protective factors for depression of elderly patients with chronic comorbidity. Living alone (OR=1.971, 95% CI:1.628~2.385) and having many kinds of chronic diseases (OR=1.795, 95% CI:1.382~2.332) were independent risk factors for depression. Conclusions The incidence of depression and anxiety in elderly patients with chronic disease comorbidity is high. The independent risk factors of anxiety and depression are living alone and having many kinds of chronic diseases. Active psychological intervention and social support should be carried out for these elderly patients with chronic comorbidity.
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