上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

社区心理卫生服务对老年人抑郁、焦虑、幸福感的影响

占归来1，李晨虎1，赵立宇1，李君1，吴彦2   

  1. 1.上海市徐汇区精神卫生中心， 上海 200232； 2.上海交通大学 医学院附属精神卫生中心， 上海 200030
  • 出版日期:2015-06-28 发布日期:2015-07-30
  • 通讯作者: 吴彦, 电子信箱: drwuyan@163.com。
  • 作者简介:占归来（1974—）， 男， 副主任医师， 学士; 电子信箱: zgltd2004@sina.com。
  • 基金资助:

    上海市徐汇区医学科研重点项目（SHXH201113）

Effects of community mental health services on depression, anxiety, and happiness of the elderly

ZHAN Gui-lai1, LI Chen-hu1, ZHAO Li-yu1, LI Jun1, WU Yan2   

  1. 1.Shanghai Xuhui District Mental Health Center, Shanghai 200232, China; 2.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2015-06-28 Published:2015-07-30
  • Supported by:

    Shanghai Xuhui District Medical Research Key Project， SHXH201113

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摘要：

目的 探讨开展社区心理卫生服务对社区老年人心理健康状况的影响。方法 从上海市徐汇区龙华街道整群随机抽取4个居民委员会，根据知情同意、自愿原则，按照入组标准选取研究对象。完成全程研究者共1 431名，分为观察组（n=692）和对照组（n=739）。针对观察组开展一系列的社区心理卫生服务。分别在基线时、6个月末、12个月末进行患者健康问卷抑郁量表（PHQ-9）、焦虑筛查问卷（GAD-7）、总体幸福感量表（GWB）评分。结果 ①GWB评分组内比较：观察组对健康的担心、精力、对生活满足和兴趣、忧郁或愉快的心境、松弛与紧张（焦虑）因子分差异均有统计学意义（P=0.00），仅对情感和行为控制因子分差异无统计学意义（F=0.32，P=0.63）；对照组仅对健康的担心因子分（F=4.33，P=0.02）及松弛和紧张（焦虑）因子分（F=154.26，P=0.00）差异有统计学意义。②GWB评分组间比较：在6个月末时，对健康的担心、忧郁和愉快的心境因子分，观察组已明显优于对照组，差异有统计学意义（P<0.01）；在12个月末时，对生活满足和兴趣、对健康的担心、忧郁和愉快的心境、松弛和紧张（焦虑）因子评分，观察组优于对照组，差异有统计学意义（P<0.01）。③观察组在基线、6个月末和12个月末PHQ-9总分（F=1 603.27）及GAD-7总分（F=653.68）下降，GWB总分（F=2 158.86）上升，在干预前后差异有统计学意义（P<0.01）；而对照组差异均无统计学意义（F=0.42，P=0.57；F=1.29，P=0.28；F=3.69，P=0.06）。④基线时组间PHQ-9、GAD-7、GWB评分差异无统计学意义（P>0.05）；而6个月末及12个月末时组间评分比较，差异均有统计学意义（P<0.01）。结论 开展社区心理卫生服务对社区老年人心理健康状况有改善，持续开展效果更明显。

关键词: 社区, 心理卫生服务, 抑郁, 焦虑, 幸福感

Abstract:

Objective To explore the effects of community mental health services on the mental health of the elderly. Methods Four resident committees of Longhua Street community of Xuhui District in Shanghai were randomly selected and a total of 1 431 subjects were enrolled and finished the study according to the principle of voluntary and informed consent. Subjects were randomly divided into the observation group (n=692) and control group (n=739). The observation group received a series of community mental health services. Subjects were evaluated by the patient health questionnaire-9 (PHQ-9), generalized anxiety disorder screening scale-7 (GAD-7), and general well-being schedule (GWB) at baseline and by the end of 6 months and 12 months. Results ①Intra-group comparison of the GWB scores indicated that for the observation group, the differences of scores of worries about health, vigor, satisfaction of and interest in life, doldrums or pleasant mood, and relaxation and tension (anxiety) were statistically significant (P=0.00), except the control of the emotions and behavior (F=0.32, P=0.63). For the control group, the differences of scores of worries about health (F=4.33, P=0.02) and relaxation and tension (anxiety) (F=154.26, P=0.00) were statistically significant. ②Inter-group comparison of the GWB scores indicated that by the end of 6 months, scores of worries about health and doldrums or pleasant mood of the observation group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). By the end of 12 months, scores of satisfaction of and interest in life, worries about health, doldrums or pleasant mood, and relaxation and tension (anxiety) of the observation group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). ③For the observation group, the total score of PHQ-9 (F=1 603.27) and total score of GAD-7 (F=653.68) at baseline and by the end of 6 and 12 months decreased, while the total score of GWB (F=2 158.86) increased. The differences before and after intervention were statistically significant (P<0.01). The differences of the control group were not statistically significant (F=0.42, P=0.57; F=1.29, P=0.28; F=3.69, P=0.06). ④The differences of scores of PHQ-9, GAD-7, and GWB at baseline between two groups were not statistically significant (P>0.05), while the differences of scores by the end of 6 and 12 months between two groups were statistically significant (P<0.01). Conclusion The implementation of community mental health services can improve the mental health status of the elderly and the effect of persistent implementation will be more remarkable.

Key words: community, mental health services, depression, anxiety, happiness