冠心病患與慢性腎臟衰竭病患的憂鬱、焦慮程度及生活品質

Anxiety/Depressive Symptoms and Quality of Life in Patients with Coronary Artery Disease for Chronic Renal Failure

10.29478/TJP.200703.0007

胡智棻(Chih-Fen Hu)；陳志剛(Chih-Gang Chen)；朱柏齡(Pau-Ling Chu)；林石化(Shih-Hua Lin)；曹殿萍(Tien-Ping Tsao)；洪國峻(Gou-Jieng Hong)；葉啟斌(Chin-Bin Yeh)

冠心病患 ； 慢性腎臟衰竭病患 ； 嚴重型憂鬱症 ； 生活品質 ； coronary artery disease ； chronic renal failure ； depression ； quality of life

台灣精神醫學

21卷1期（2007 / 03 / 01）

53 - 61

繁體中文

目的：比較兩種血管性疾病：冠心病患與慢性腎臟衰竭病患的憂鬱及焦慮盛行率、嚴重程度及生活品質是否有所不同。方法：以某醫學中心30名冠心病患及30名慢性腎臟衰竭病患為研究對象，依據結構式問卷評量個案，分析憂鬱焦慮程度及生活品質之相關。最後再以SPSS描述與分析資料。結果：兩組病患均約有40%符合DSM-IV嚴重憂鬱症；而慢性腎臟衰竭病患生活品質較差；冠心病患則明顯有較高的焦慮指數，兩組病患的生活品質與憂鬱焦慮及衝動等因素均明顯相關。結論：本研究顯示不同的壓力型態或不同的疾病，對合併焦慮及憂鬱的症狀嚴重度及對生活品質的影響有所不同。

Objectives: The present study was designed to compare the prevalence and severity of anxiety and depression, and the quality of life of patients with coronary artery disease and patients with chronic renal failure receiving hemodialysis. Methods: From January to June 2005, 30 inpatients with coronary artery disease and 30 patients with chronic renal failure receiving hemodialysis were recruited into our study in a medical center. The patients were interviewed and severity of anxiety, depression and quality of life were evaluated using semi-structured and self-reporting questionnaires. The data were collected and analyzed with SPSS 13.0. Results: There were 40% of patients who met the criteria for a major depressive disorder. Patients with chronic renal dialysis had significantly poorer quality of life than patients with coronary artery disease. However, the patients with coronary artery disease had significantly more severe anxiety symptoms. Conclusion: The results of our study indicated that all the patients had more depressive symptoms than the general population. It indicated that the comorbidity of anxiety and/or depression, and quality of life were correlated with the patterns of stressors among patients with medical diseases.

1. American Psychiatric association(1994).Diagnostic and Statistical Manual of Mental Disorder.DSM-IV.
2. Dogan E,Erkoc B,Eryonucu B,Sayarlioglu H,Agargun MY(2005).Relation between depression, some laboratory parameters, and quality of life in hemodialysis patients.Ren Fail,27,695-9.
3. HRSD、胡海國(1991)。精神醫學診斷手冊（第二版），265-7。
4. Kimmel PL,Peterson RA(2005).Depression in end-stage renal disease patient treated with hemodialysis: tools, correlates, outcomes, and needs.Semin Dial,18,1991/7/1.
5. Krishnan KR(2005).Treatment of depression in the medically ill.J Clin Psychopharmaeol,25,14-8.
6. Lopes AA,Albert JM,Young EW(2004).Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOFFS.Kidney Int,66,2047-53.
7. Malzberg B(1937).Mortality among patient with involutional melancholia.Am J Psychiatry,93,1231-8.
8. Massart N,Triffaux JM(2005).Depression and coronary artery disease.Rev Mod Liege,60,931-8.
9. Michalsen A,Grossman P,Lehmatm N(2005).Psychological and quality-of-life outcomes from a comprehensive stress reduction and lifestyle program in patients with coronary artery disease: results of a randomized trial.Psychother Psychosom,74,344-52.
10. Odden MC,Wooley MA,Shlipak MG(2006).Depression, stress, and quality of life in persons with chronic kidney disease: the Heart and Soul Study.Nephron Clin Pract,103,1-7.
11. Roccella M,Leggio L,Parisi L,Turdo G,Testa D(2005).The quality of life in developing age subjects with chronic renal diseases.Minerva Pediatr,57,119-28.
12. Rutledge T,Reis SE,Olson M(2006).Depression is associated with cardiac symptoms, mortality risk, and hospitalization among women with suspected coronary disease.Psychosom Med,68,217-23.
13. Shimbo D,Davidson KW,Haas DC,Fuster V,Badimon JJ(2005).Negative impact of depression on outcome in patient with coronary artery disease: mechanism, treatment consideration, and future directions.Journal of Thrombosis & Hemostasis,3,897-908.
14. Srinivasan, K,Srinivasan J,Williel L(2004).A study of lifetime prevalence of anxiety and depressive disorders in patient presenting with chest pain to emergency medicine.Gen Hosp Psychiatry,26,470-4.
15. Tossani E,Caceano P,Fava M(2005).Depression and renal disease.Semin Dial,18,73-81.
16. Tyrrell J,Paurel L,Cadec B,Capezzali E,Poussin G(2005).Older patients undergoing dialysis treatment: Cognitive function, depressive mood and health-related quality of life.Aging & Mental Health,9,374-9.
17. Wellbery C(2004).Cardiac function vs. depression on health status IN CAD.Am Fam Physician,69,665-6.
18. Wuerth D,Finkelstein SH,Finkeletein FO(2005).The identification and treatment of depression in patient maintained on dialysis.Semin Dial,18,142-6.
19. Yao G,Chung CW,Yu CF,Wang JD(2002).Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version.J. Formos Med Assoc,101,342-51.
20. 衛生統計資訊網
21. 李欣南、李貫棠(2000)。抗憂鬱劑對心血管影響之探討。臨床藥學，16，142-8。
22. 李欣南、張明永、詹道明(2005)。憂鬱症合併之心血管疾病。台灣醫學，9，265-76。
23. 李進賢、柯慧貞、翁儷禎、廖聆岑、陸汝斌(2002)。衝動性量表的發展：心理計量特性及其與反社會性格障礙之關係。中華心理學刊，44，109-19。
24. 李碧娥、林秋菊、吳淑鈴、徐惠禎(2004)。與洗腎機共存：末期腎病變患者之生命經驗。長庚護理，15，121-30。
25. 貝克焦慮量表指導手冊、AARON T. BECK、ROBERT A. STEER、林一真(2000)。中國行為科學社。
26. 林季宏、曾冬勝、龍佛衛、郭泰松(2000)。尿毒症患者合併有憂鬱症之文獻回顧。當代醫學，27，598-603。
27. 陳秀珊(2002)。心血管疾病病人選用抗憂鬱藥物的考量。藥學雜誌，18，72-80。
28. 陳金柱、呂炎原、吳尚德、郭宗正(2005)。憂鬱症是心血管與腦血管疾病的危險因子。台灣醫界，48，16-9。

1. 蘇淑芬,吳孟珊,何崇萍(2018)。憂鬱症影響冠心症患者不良預後及生活品質。台灣專科護理師學刊，5(1)，75-82。