Analysis of clinical and psychological characteristics in 250 patients with fibromyalgia / 中华内科杂志

To analyze the clinical and psychological characteristics of fibromyalgia (FM), so as to further understand and improve the capability of identifying FM. The clinical data of 250 FM patients diagnosed in the outpatient clinic of the Department of Rheumatology, the First Medical Center, Chinese PLA General Hospital, from December 2019 to September 2021, were collected and analyzed. The patients aged 40 (31.0, 52.3) years, including 188 female patients (75.2%) and 62 male patients (24.8%). There was a statistically significant difference in age comparison between female [42.5 (33.0,54.0) years] and male patients [32.5 (27.8,43.5) years] ( P<0.001). The score of pain degree was 6 (4, 8), and [7 (5, 8)] of female patients was higher than [6 (4, 7)] of the male patients ( P=0.040). The widespread pain index (WPI) was 13 (10,15). The regions with high pain incidence were left shoulder girdle (87.2%, 218/250), right shoulder girdle (86.8%, 217/250), upper back (86.4%, 216/250), neck (79.6%, 199/250) and lower back (77.6%, 194/250) and etc. The incidence of chest pain in female patients (55.3%, 104/188) was lower than that in male patients (75.8%, 47/62) ( P=0.004). The symptom severity scale (SSS) score was 8 (7-10). 74.6% (185/248) suffered from anxiety and 77.5% (193/249) suffered from depression in 249 patients. Female patients were more common in FM patients than male patients, the median age of female patients was older than that of male patients, and the median score of pain severity of female patients was higher than male patients. Shoulders girdle, upper back, neck and lower back were the most frequently reported pain regions, and the incidence of chest pain in female patients was lower than that in male patients. The incidence of major non-painful symptoms was high and the proportion with anxiety or depression was high. The above clinical features are very helpful for early diagnosis of FM.

Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities.</p><p><b>METHODS</b>A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up.</p><p><b>RESULTS</b>A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123).</p><p><b>CONCLUSION</b>There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.</p>

Recognition of depression and related risk factors among non psychiatric doctors in tertiary general hospital outpatients in Beijing / 中华内科杂志

0bjective To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals.Methods A cross-sectional investigation was used to screen the outpatients,and depression was diagnosed according to Mini International Neuropsyehiatric Interview (MINI).Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics.Results Among 248 cases of depression,30(12.1%)were referred to psychiatrists,28(8.9%)managed with antidepressant or sedative hypnotics.The identification rate of depression by physicians was 21.0%.and the identification rate by neurologist was 40.4%,which is higher than the rate by cardiologist(22.4%),gastrointestinal physician(3.8%)and gynecologist(2.0%)(χ2=61.077,P<0.05).Visiting neurology department,severity of life impairment,with psychotic distress history,hadpsychological complaints.co-morbidity with anxiety related to the physician's identification of depression.Among the psychological complaints.only mood disorder and insomnia were related to the physician'sidentification of depression.Conclusions The level of depression identification by physician was low,the level of neurologist wag higher than that of cardiologist,gastrointestinal physician and gynecologist.The patient with serious life impairment,psychotic distress history,mood disorder and insomnia complaints was asily to be identified.

The prevalence of depression and anxiety in gastrointestinal out-patients of tertiary general hospitals in Beijing / 中华内科杂志

Objective To explore the prevalence and physician's recognition of depression and anxiety disorder in gastrointestinal out-patients of three tertiary general hospitals in Beijing. Methods A hospital-based cross-sectional survey was conducted in the gastrointestinal out-patient departments of three tertiary general hospitals in Beijing from May to June 2007. Total 517 subjects were recruited consecutively within a one month period. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Results Among the 517 cases, 301 had a HADS score of 8 and above and 244 were interviewed by psychiatrists; the response rate was 81.1%. The prevalence according to Diagnostic and Statistical Manual of Mental Disorders Fourth edition of depressive disorders and anxiety disorders in gastrointestinal outpatients were 15.3%, depressive disorders were 12. 0%, anxiety disorders were 6. 4%, depression combined anxiety disorder was 3. 0%. The prevalence of depression, anxiety, depression combined anxiety were not different between genders (x2 = 0. 874, x2 = 1.797,x2 =0.518, P >0.05) and among different age group ( 18-34, 35-54, ≥55 years old) (x2 = 1. 084,2 = 2. 735, 2 = 0. 350, P 0. 05 ). Gastritis and gastrointestinal dysfunction were the major diagnoses in patients with depression and/or anxiety disorders, the rates were 30. 6% and 26. 4% respectively. The rate of identification of depression and anxiety disorder by physicians was 2. 8%. Conclusion Gastrointestinal out-patients have a high prevalence of depression and anxiety disorder and the rate of identification by physicians was very low.

An analysis of psychological problems of patients in cardiology clinic / 中华内科杂志

Objective To explore the current condition of psychological problems of patients in cardiology clinic. Methods A total of 347 patients in the cardiology clinic of Prof. HU Da-yi were screened by self-rating depression scale(SDS),Self-rating anxiety scale(SAS),Hamilton rating scale for depression(HRSD)and Hamilton anxiety scale(HAMA). Results The rates of patients with somatic disease only or with psychological disorder only were 52.4%and 12.7%, the rate of somatic disease accompanied with psychological disorder was 27.7%. For the patients with psychological problems, there were 31 cases with depression(8.9%),62 cases with anxiety(17.9%),and 28 cases(8.1%) suffering from mixed depression and anxiety the diagnosis of cardiovascular disease,functional disease or digestive disease was always used by doctors for the patients with psychological problems only,as they always did not accept the diagnosis of psychological disorder. Conclusions It is very common that patients in cardiology clinic department suffered from psychological problems. The patients with psychological disorder only were easily misdiagnosed as somatic disease especially cardiovascular disease.

Characteristics of Consultation-Liaison Psychiatry in a Psychiatric Hospital in Beijing / 中国心理卫生杂志

Objective:To explore the characteristics of consultation-liaison psychiatry service in general hospital.Methods:Totaly 541 consecutive inpatients from general hospitals were enrolled,who were referred to the consultation-liaison psychiatry service of a psychiatric hospital during a one-year period.The data was analyzed,including demographic characteristics,reasons for referral,referral department,psychiatric diagnosis according to criteria in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV),and psychiatric management suggestions.Results:The rate of psychiatric consultation in the hospital which applied for the most consultations was 1.0%.The patients with psychiatric history(22.6%)were most likely to be referred.The principal reasons for psychiatric referral were psychotic episode(31.8%),depression(13.1%),and anxiety disorder(10.9%).According to DSM-IV,cognitive disorders(32.2%),depressive disorder(17.7%),anxiety disorder(13.1%),schizophrenia and other psychotic disorders(9.8%)were the major psychiatric diagnoses.The psychiatrists prescribed antipsychotics in 72.8% patients,gave nursing and behavior suggestions in 39.2% patients,gave following-up suggestion in 38.1% patients,and provided suicide prevention in 10.2% patients.Conclusion:It is important to expand the consultation-liaison psychiatry service in general hospital.And it is necessary to improve the physicians' ability in recognition and treatment of psychiatric disorder in patient with physical illness.