Analysis of anxiety and depression and influencing factors of patients with chronic hepatitis B virus infection
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摘要: 目的 了解不同类型慢性乙型肝炎病毒(HBV)感染者的焦虑和抑郁状况及其影响因素,分析疾病严重程度对患者焦虑及抑郁状况的影响。 方法 调查分析中山大学附属第三医院2018年10月—2019年3月期间HBV感染的住院患者257例,其中慢乙肝83例、肝衰竭38例、肝硬化107例、肝癌29例。给予SAS和SDS焦虑抑郁量表评估,并采集社会人口学基本特征、生化指标及彩超资料,采用单因素分析法对HBV感染者发生焦虑和抑郁的影响因素进行分析。 结果 不同类型慢性乙型肝炎病毒感染者焦虑和抑郁的总体发生率分别为24.5%与45.9%,以肝衰竭患者尤为明显(焦虑和抑郁发生率分别为36.9%与73.7%);且不同临床类型患者的焦虑及抑郁程度分级亦存在明显差异,肝衰竭中重度抑郁及焦虑的比例均明显高于其他组,其中轻度抑郁占50.0%,中重度抑郁占23.7%且中重度焦虑的发生率高达15.8%;另外肝病MELD及Child-Pugh分级与SAS和SDS评分呈正相关,Child-Pugh A、B、C级别间抑郁评分和程度差异有统计学意义(均P<0.05),MELD分层间抑郁评分差异有统计学意义(P<0.05);此外患者性别、文化层次、付费方式及收入等方面亦与抑郁及焦虑的发生相关。 结论 HBV感染者焦虑或抑郁问题突出,且病情的严重程度与焦虑抑郁相关,女性、学历低、自费及家庭收入低是HBV感染者发生焦虑抑郁的影响因素,临床应予以重视。Abstract: Objective To investigate the anxiety and depression status of patients with different clinic type of chronic hepatitis B virus infection (HBV) and its influencing factors, and to analyze the influence of disease severity on patients' anxiety and depression status. Methods A total of 257 cases of patients with chronic HBV infection in the Third Affiliated Hospital of Sun Yat-sen University Infectious Diseases department from Oct-2018 to Mar-2019,including chronic hepatitis B (83 cases), liver failure (38 cases), cirrhosis (107 cases), liver cancer (29 cases). SAS and SDS Depression Scale anxiety assessment were given, basic socio-demographic characteristics, biochemical markers and ultrasound data were collected. Single factor analysis method was used to analyze the influencing factors of anxiety and depression in HBV infected patients. Results The incidence of anxiety and depression in patients with different types of chronic HBV infection was 24.5% and 45.9% respectively, especially in patients with liver failure (the incidence of anxiety and depression was 36.9% and 73.7% respectively). The incidence of depression and anxiety in patients with different chronic HBV infection was significantly different. The proportion of moderate & severe depression and anxiety in liver failure patients was significantly higher than others. Among them, mild depression accounts for 50.0%, moderate and major depression accounts for 23.7%, and moderate and major anxiety accounts for 15.8%; The severity of liver disease MELD and child-pugh scores were positively correlated with SAS and SDS, and there were statistically significant differences in depression scores among child-pugh grades A, B and C (all P<0.05), or MELD hierarchy (P<0.05). In addition, gender, cultural level, Medicare payments method and household income was also correlated with the occurrence of depression and anxiety. Conclusion Anxiety or depression in patients with chronic HBV infection are very common, and the severity of the disease is related to anxiety and depression. Women, low educational background, low self-pay and low family income are the influencing factors of anxiety and depression in HBV-infected patients, which should be paid more attention in clinical practice.
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Key words:
- Hepatitis B virus /
- Anxiety /
- Depression
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