焦虑障碍患者的焦虑水平、述情障碍程度对其生活质量的影响

doi:10.3969/j.issn.1674-8115.2024.05.006

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (5): 584-590.doi: 10.3969/j.issn.1674-8115.2024.05.006

• 论著 · 临床研究 • 上一篇

焦虑障碍患者的焦虑水平、述情障碍程度对其生活质量的影响

苏珊珊(), 蒋文晖(), 王书婷, 徐觅真, 任雪晴, 仇剑崟()

上海交通大学医学院附属精神卫生中心心理咨询门诊部，上海 200030

收稿日期:2023-08-04 接受日期:2024-05-08 出版日期:2024-05-28 发布日期:2024-05-28
通讯作者: 仇剑崟 E-mail:su.lingshan@163.com;jwh_0303@163.com。;jianyin_qiu@163.com
作者简介:苏珊珊（1986—），女，副主任医师，硕士；电子信箱：su.lingshan@163.com
蒋文晖（1974—），女，副主任医师，硕士；电子信箱：jwh_0303@163.com。第一联系人：*为共同第一作者。
基金资助:
上海申康医院发展中心(SHDC2020CR1027B);上海市精神卫生中心院级课题(2019-YJ12);国家自然科学基金(81971265)

Impact of anxiety levels and alexithymia degree on the quality of life in patients with anxiety disorders

SU Shanshan(), JIANG Wenhui(), WANG Shuting, XU Mizhen, REN Xueqing, QIU Jianyin()

Department of Psychological Counseling Clinic, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China

Received:2023-08-04 Accepted:2024-05-08 Online:2024-05-28 Published:2024-05-28
Contact: QIU Jianyin E-mail:su.lingshan@163.com;jwh_0303@163.com。;jianyin_qiu@163.com
Supported by:
Shanghai Hospital Development Center(SHDC2020CR1027B);Hospital Level Research Project of Shanghai Mental Health Center(2019-YJ12);National Natural Science Foundation of China(81971265)

摘要/Abstract

摘要：

目的·评估焦虑障碍患者的焦虑水平、述情障碍程度与其生活质量之间的关系。方法·选择2020年10月1日—2023年3月31日期间在上海交通大学医学院附属精神卫生中心门诊收治的焦虑障碍患者为研究对象，经排除后最终纳入患者438例；其中，广泛性焦虑障碍患者271例，惊恐障碍患者101例，社交焦虑障碍患者48例，场所恐惧症患者12例，特定恐惧症患者6例。分别采用汉密尔顿焦虑量表（Hamilton Anxiety Scale，HAMA）、汉密尔顿抑郁量表-17项（Hamilton Depression Scale-17，HAMD-17）、多伦多述情障碍量表-20项（the twenty-item Toronto Alexithymia Scale，TAS-20）、世界卫生组织生活质量测定简表（World Health Organization Quality of Life Scale-Brief Form Questionnaire，WHOQOL-BREF）评估患者的焦虑水平、抑郁水平、述情障碍程度及生活质量，并对不同亚型焦虑障碍患者的量表得分进行评估。采用Spearman相关系数对焦虑障碍患者的焦虑水平、抑郁水平、述情障碍程度与生活质量进行相关分析，并使用逐步回归模型探索影响焦虑障碍患者生活质量的关键变量。结果·不同亚型焦虑障碍患者在HAMA评分、HAMD-17评分、TAS-20评分间的差异无统计学意义，但在WHOQOL-BRIEF评分上差异具有统计学意义（H=10.076，P=0.039）。Spearman相关分析的结果显示，焦虑障碍患者的WHOQOL-BRIEF评分与HAMA评分、HAMD-17评分、TAS-20评分均呈负相关（r=-0.256，P=0.000；r=-0.311，P=0.000；r=-0.342，P=0.000）。逐步回归分析的结果显示，年龄、HAMA评分、HAMD-17评分及TAS-20评分均对患者的生活质量有较大影响（均P<0.05）。结论·不同亚型焦虑障碍患者的生活质量有所不同，焦虑水平、抑郁水平及述情障碍程度均是影响焦虑障碍患者生活质量的关键变量。

关键词: 焦虑障碍, 焦虑水平, 抑郁水平, 述情障碍, 生活质量

Abstract:

Objective ·To evaluate the relationship between anxiety level, alexithymia degree and quality of life in patients with anxiety disorders. Methods ·Anxiety disorder patients admitted to the outpatient department of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from October 1, 2020 to March 31, 2023 were selected as the research subjects, and 438 patients were ultimately included after exclusion. Among them, there were 271 patients with generalized anxiety disorder, 101 patients with panic disorder, 48 patients with social anxiety disorder, 12 patients with agoraphobia, and 6 patients with specific phobia. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale-17 (HAMD-17), the twenty-item Toronto Alexithymia Scale (TAS-20) and World Health Organization Quality of Life Scale-Brief Form Questionnaire (WHOQOL-BREF) were used to assess the patients' anxiety level, depression level, alexithymia degree and quality of life, respectively, and the scale scores of patients with different subtypes of anxiety disorders were evaluated. Spearman correlation coefficient was used to analyze the correlation between anxiety level, depression level, alexithymia degree and quality of life in patients with anxiety disorders. Stepwise regression model was used to analyze the key variables affecting the quality of life in patients with anxiety disorders. Results ·There were no significant differences in HAMA score, HAMD-17 score and TAS-20 score among patients with different subtypes of anxiety disorders, but the differences in WHOQOL-BRIEF score were statistically significant (H=10.076, P=0.039). The results of Spearman correlation analysis showed that the WHOQOL-BRIEF score of anxiety disorder patients was negatively correlated with HAMA score, HAMD-17 score and TAS-20 score (r=-0.256, P=0.000; r=-0.311, P=0.000; r=-0.342, P=0.000). The results of stepwise regression analysis showed that age, HAMA score, HAMD-17 score and TAS-20 score had significant impact on the quality of life of patients (all P<0.05). Conclusion ·The quality of life in patients with different subtypes of anxiety disorders is different. The anxiety level, depression level and alexithymia degree are the key variables affecting their quality of life.

Key words: anxiety disorder, anxiety level, depression level, alexithymia, quality of life

中图分类号:

R749

苏珊珊, 蒋文晖, 王书婷, 徐觅真, 任雪晴, 仇剑崟. 焦虑障碍患者的焦虑水平、述情障碍程度对其生活质量的影响[J]. 上海交通大学学报（医学版）, 2024, 44(5): 584-590.

SU Shanshan, JIANG Wenhui, WANG Shuting, XU Mizhen, REN Xueqing, QIU Jianyin. Impact of anxiety levels and alexithymia degree on the quality of life in patients with anxiety disorders[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(5): 584-590.

图/表 5

参考文献 28

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Item	Generalized anxiety disorder patients (n=271)	Panic disorder patients (n=101)	Social anxiety disorder patients (n=48)	Agoraphobia patients (n=12)	Specific phobia patients (n=6)	H/χ² value	P value
Gender/n(%)						10.340	0.036
Male	118 (43.54)	29 (28.71)	22 (45.83)	3 (25.00)	4 (66.67)
Female	153 (56.46)	72 (71.29)	26 (54.17)	9 (75.00)	2 (33.33)
Age/year	35.00 (28.00, 43.00)	34.00 (27.00, 41.00)	28.00 (22.00, 35.00)	32.00 (27.00, 39.75)	32.50 (21.75, 31.00)	6.415	0.000

Item	Generalized anxiety disorder patients (n=271)	Panic disorder patients (n=101)	Social anxiety disorder patients (n=48)	Agoraphobia patients (n=12)	Specific phobia patients (n=6)	H/χ² value	P value
Gender/n(%)						10.340	0.036
Male	118 (43.54)	29 (28.71)	22 (45.83)	3 (25.00)	4 (66.67)
Female	153 (56.46)	72 (71.29)	26 (54.17)	9 (75.00)	2 (33.33)
Age/year	35.00 (28.00, 43.00)	34.00 (27.00, 41.00)	28.00 (22.00, 35.00)	32.00 (27.00, 39.75)	32.50 (21.75, 31.00)	6.415	0.000

Scale	Generalized anxiety disorder patients (n=271)	Panic disorder patients (n=101)	Social anxiety disorder patients (n=48)	Agoraphobia patients (n=12)	Specific phobia patients (n=6)	H value	P value
HAMA/score	20.00 (16.00, 24.00)	21.00 (17.00, 25.75)	19.00 (16.00, 24.00)	21.50 (16.00, 29.5)	23.00 (16.75, 31.50)	4.809	0.307
HAMD-17/score	11.67 (9.50, 14.00)	11.34 (8.25, 14.00)	10.36 (8.00, 13.00)	11.17 (8.25, 14.00)	9.67 (4.50, 15.75)	1.705	0.148
TAS-20/score	30.00 (26.00, 35.25)	30.50 (26.00, 37.75)	32.00 (29.00, 36.00)	31.00 (27.00, 34.75)	28.00 (19.00, 42.25)	2.465	0.651
WHOQOL-BRIEF/score	50.21 (44.94, 56.95)	51.52 (46.71, 55.71)	46.83 (42.69, 53.31)	49.83 (45.02, 57.32)	46.73 (37.47, 57.78)	10.076	0.039

Scale	Generalized anxiety disorder patients (n=271)	Panic disorder patients (n=101)	Social anxiety disorder patients (n=48)	Agoraphobia patients (n=12)	Specific phobia patients (n=6)	H value	P value
HAMA/score	20.00 (16.00, 24.00)	21.00 (17.00, 25.75)	19.00 (16.00, 24.00)	21.50 (16.00, 29.5)	23.00 (16.75, 31.50)	4.809	0.307
HAMD-17/score	11.67 (9.50, 14.00)	11.34 (8.25, 14.00)	10.36 (8.00, 13.00)	11.17 (8.25, 14.00)	9.67 (4.50, 15.75)	1.705	0.148
TAS-20/score	30.00 (26.00, 35.25)	30.50 (26.00, 37.75)	32.00 (29.00, 36.00)	31.00 (27.00, 34.75)	28.00 (19.00, 42.25)	2.465	0.651
WHOQOL-BRIEF/score	50.21 (44.94, 56.95)	51.52 (46.71, 55.71)	46.83 (42.69, 53.31)	49.83 (45.02, 57.32)	46.73 (37.47, 57.78)	10.076	0.039

Item	HAMA score	HAMD-17 score	WHOQOL-BRIEF score
HAMA score	‒	‒	‒
HAMD-17 score	0.388 (0.000)	‒	‒
WHOQOL-BRIEF score	-0.256 (0.000)	-0.311 (0.000)	‒
TAS-20 score	0.162 (0.001)	0.220 (0.000)	-0.342 (0.000)

焦虑障碍患者的焦虑水平、述情障碍程度对其生活质量的影响

Impact of anxiety levels and alexithymia degree on the quality of life in patients with anxiety disorders

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参考文献 28

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Metrics

Independent variable	Nonnormalized coefficient	Standardization coefficient		t value	P value	VIF	R²	Adjusted R²	F value
Independent variable	B	Standard error	β	t value	P value	VIF	R²	Adjusted R²	F value
constant	65.147	2.426	0	26.849	0.000	‒	0.208	0.200	25.804
TAS-20 score	-0.283	0.048	-0.275	-5.876	0.000	1.086
HAMD-17 score	-0.454	0.113	-0.198	-4.009	0.000	1.217
HAMA score	-0.175	0.069	-0.125	-2.543	0.011	1.205
Age	0.087	0.038	0.103	2.264	0.024	1.027

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