| Background:Depressive disorder is a common chronic mental illness with four highs(That is high prevalence,high recurrence rate,high disability and high suicide rate),which has become one of the four major health problems in the world.The disease burden caused by depressive disordeis severe and multi-level,it not only causes serious harm to themselves,but also to family members and society.Due to the lack of public awareness of such diseases,patients often visit the general hospital for physical symptoms for the first time,rather than professional psychiatric hospitals.The prevalence of depressive disorder in general hospitals is getting higher and higher.Depression has a high incidence of insomnia,and it has a complex bidirectional relationship with insomnia.The quality of life of patients with depression is a problem that has recently received much attention,the remission of quality of life lags behind the relief of symptoms.Therefore,it is very meaningful to study the relationship between depression and quality of life.Objectives:This study was based on a large sample of outpatient clinics in general hospitals in South China.On the one hand,analysis of quality of life characteristics of patients with depressive symptoms and insomnia;On the other hand,analyze the characteristics of quality of life of patients with major depressive disorder;and discuss the factors related to the quality of life of patients with major depressive disorder from the aspects of demographic characteristics and clinical data.To increase the emphasis of outpatient physicians and patients in general hospitals on depression and strengthen interventions to improve the quality of life of patients and promote better return of patients to society.Methods:This study conducted a cross-sectional study of patients in the department of neurology,gynecology,gastroenterology,and cardiovascular medicine at the general hospital in guangzhou from March to June 2016,after meeting the inclusion and exclusion criteria,the final 3254 respondents were included in the study.This survey uses a self-designed general survey questionnaire to collect demographic data of the population;Use Patient Health Questionnaire-9 to assess whether a patient has depressive symptoms;Use Generalized Anxiety Disorder-7 to assess the patient’s anxiety status;Use the Patient Health Questionnaire-15 to assess the patient’s body status;using a sleep questionnaire to assess whether the patient has insomnia;Use the12-item Short Form Health Survey to assess the quality of life of patients;Mini International Neuropsychiatric Interview was used to define the diagnosis of depression.An independent sample t-test was used for comparisons between groups for quantitative data;Chi-square test is used for the comparison between groups of qualitative data;The related factors of quality of life in patients with major depressive disorder were analyzed by Spearman rank correlation analysis and multiple stepwise regression analysis.Results:A total of 5376 patients participated in the survey,of which 39 patients did not report age,and 53 patients were younger than 18 years old,2030 patients did not fill out the quality of life scale,so the data filled by the last 3254 patients met the survey.There are 135 people with severe depressive disorder,the detection rate is 4.15%,among them,106 were women,accounting for 78.52%,and 78 were insomnia,accounting for 57.78%.The scores of quality of life in patients with depressive symptoms and insomnia were lower than those without insomnia(P<0.001),The scores of quality of life in patients with major depressive disorder were lower than those in nondepressive patients(P<0.001).The Spearman rank correlation analysis found that the quality of life of patients with major depressive disorder was negatively correlated with age(r=-0.152,P<0.05),insomnia(r=-0.279,P<0.01),PHQ-9(r=-0.320,P<0.01),PHQ-15(r=-0.304,P<0.01)and diabetes history(r=-0.166,P<0.05),positively correlated with education level(r=0.304,P<0.01).The quality of life mental health of patients with major depressive disorder was positively correlated with age(r=0.191,P<0.05),negatively correlated with education level(r=-0.206,P<0.05),GAD-7(r=-0.296,P<0.01),PHQ-9(r=-0.451,P<0.01),PHQ-15(r=-0.231,P<0.01).The differences were statistically significant.Multivariate stepwise linear regression analysis further revealed that the quality of life of patients with major depressive disorder was negatively correlated with PHQ-9(β=-0.34,P=0.001),PHQ-15(β=-0.205,P=0.031),positively correlated with the education level of junior high school and senior high school(β=0.28,P=0.011),university and above(β=0.339,P=0.004).There was a negative correlation between the quality of life and mental health of patients with major depressive disorder and PHQ-9(β=-0.37,P=0.001),education level of junior high school and high school culture(β=-0.233,P=0.049),university and above(β=-0.295,P=0.016).Conclusions:The prevalence of depressive disorders in non-psychiatric/psychology out-patient clinics of general hospitals is high,among which the prevalence of females is higher than that of males;the incidence of insomnia is higher in patients with depressive disorders.The quality of life of patients with major depressive disorders was lower than that of non-severe depressive patients.Insomnia can worsen the poor quality of life of depressed patients.The physical quality of life of patients with major depressive disorders in non-psychiatric/psychology out-patient clinics of general hospitals is related to the severity of depressive symptoms,physical symptoms,and educational level;the mental health of the quality of life of patients with major depressive disorder is related to the severity of depressive symptoms and educational level. |
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