摘要
目的调查围更年期焦虑抑郁患者的症状群分类特征、误诊的形式、消费的医疗资源。方法收集更年期焦虑抑郁患者78例和无焦虑抑郁的更年期患者36例(对照组),采用Greene更年期症状评分量表和90症状自评量表(SCL-90)分析症状群的特征,统计患者误诊的形式和确诊前的医疗费用。结果①焦虑抑郁组的SCL-90评分的躯体化因子、强迫因子、抑郁因子、焦虑因子、恐怖因子较对照组明显升高(P<0.01),尤其两组躯体化因子和焦虑因子的差异更为明显(P<0.001)。②焦虑抑郁组Greene评分的焦虑因子、抑郁因子及躯体症状因子与对照组相比明显增高,血管舒缩因子明显较低(P<0.01);性因子无明显差异。③焦虑抑郁组总体误诊率为84.62%,平均误诊频次为2.29。误诊为血管性头痛43.58%、慢性胃炎38.46%、颈椎病35.90%、高血压病34.62%、冠心病26.92%、慢性咽炎25.64%、甲亢15.38%、其他8.97%;误诊患者在误诊期间平均医疗总费用为2.41万元。结论围更年期焦虑抑郁的症状群特征复杂,尤以躯体化症状和焦虑症状的表现突出,因此更易被误诊,导致医疗资源的浪费。
Objective To investigate the symptoms characteristic of climacteric patients with menopause anxiety-depression and its misdiagnosis and medical cost. Methods Symptoms characteristics of 78 climacteric patients with anxiety-depression and 37 climacteric patients （control group） without anxiety-depression were measured by using SCL-90 Scale and Greene Climacteric Scale. The features of misdiagnosis and medical costs before final diagnosis were analysed in menopause anxiety-depression patients. Results （1）The SCL-90 scores of the anxiety-depression group were more increased on the somatization factor, oblige factor, depression factor, anxiety factor and phobophobia factor（ P 〈 0.01 ） than that of control group. Especially, the difference of the somatization factor and anxiety factor were furthermore significance between two groups （ P 〈 0. 001 ）. （2）Compared to control group,the Greene scores of the arLxiety-depression group were higher on somatization factor, depression factor and anxiety factor （ P 〈0.01 ） ,but the scores of vasomotion factor was lower （ P 〈0.01 ） and the scores of sex factor had no difference. （3）The rate of misdiagnosis was 84.62%, the average frequency of misdiagnosis was 2.29 in anxiety-depression groups. It was respectively misdiagnosed as vascular headache （ 43. 58% ）, chronic gastritis （ 38. 46% ）, cervical syndrome （ 35. 90% ）, hypertension （34.62%） ,coronaryartery disease （26.92%）, chronic pharyngitis （25.64%）, hyperthyreosis （ 15.38% ） and other diseases （8.97%）. The average medical costs of patients were 2.41 ten thousand yeans during misdiagnosis. Conclusion The symptoms were complex in women with anxiety-depression, especially the somatic and anxiety symptoms were most outstanding. So they were easily to be misdiagnosed and the medical costs were expensive.
出处
《中华全科医学》
2009年第5期517-518,521,共3页
Chinese Journal of General Practice
基金
广东省自然科学基金资助项目(06022385)
