The Correlation Between The Depression And/or Anxiety Disorder And TCM Constitution

Objective The study is to explore the distribution of TCM and clarify the susceptible constitution in depression and/or anxiety disorder patients in general hospital.Then it will analyze the correlation between depression anxiety disorder and TCM constitution and to screen the important pathogenic constitution of the depression and/or anxiety disorder in order to provide evidence based medical basis for the treatment of depression and anxiety disorder by using the mode of diagnosis and treatment of “Distinguish deseases-Distinguish constitions-Distinguish syndromes” and to give full play to the advantages of traditional Chinese medicine in the prevention and treatment of depression and anxiety disorder.MethodsThis study was adopted the method of cross-sectional investigation into 4 hospitals in Guangzhou area,2349 patients in outpatient department,from March 2016 to July 2016.The contents of the survey included the general demographic sociological data of the patients,GAD-7 and PHQ-9,MINIand TCM constition scale.Then,SPSS 20 statistical software was used for data analysisResultsThis study included 2349 outpatients in a general hospital,of which 705 were male and 1644 women were women.The age is 37.10 ±14.08 years and the range is 18-87 years.The years of the education is 11.23 ±3.90 years and the range is 0-23 years.There were 715 cases of obstetrics and gynecology,659 cases in the departmentof the neurology,575 cases in the department of gastroenterology and 400 cases in the cardiovascular department.There were 550 unmarried,1737 married or cohabited,27 divorced and 35 widowed.Then 1008 were of town accouts and 1341 were rural accouts.There were 1562 cases of self-pay,692 cases of social medical insurance,85 cases of public medical treatment and 10 cases of commercial insurance.The number of family history of mental illness was 673,and the number of family without history of mental illness was 1676.The result of GAD-7 scale and PHQ-9 in this study showed that GAD-7 scale score was 4.39 ± 4.83,and there were significant difference between the anxiety group and non anxiety group in gender,residence,no health insurance,no family history of mental disorders,monthly income,age.PHQ-9 scale was 4.88 ± 4.90 and there was significant difference between the depressive group and the non depressive group in terms of marriage,residence location,residence,medical insurance,family history of mental illness,life status and age.In this study,1138 cases about 48.4%(1138/2349)were screened positive for GAD-7 and / or PHQ-9 scale,while 673 cases about 59.1%(673/1138)agreed to enter psychiatric interviews.There were 191 cases about 8.1%(191/2349)for the diagnosis of anxiety disorder,239 cases about 10.2% for the diagnosis of depression disorder,88 cases about 3.7%(88/2349)for the diagnosis of comorbid anxiety and depression,342 cases about 14.6%(342/2349)for any diagnosis of anxiety and/or depression disorder.There were significant difference between the anxiety disorder group and the non-anxietydisorder group in terms of family history of mental illness,age,GAD-7 scores and PHQ-9 scores.There was significant difference between the depression group and the non-depression group in terms of family history of mental illness,medical issurence,the year of education,GAD-7 scores and PHQ-9 scores.In this study,balanced constitution group included 718 subjects(30.6%)and unbalanced constitution group included 1631 subjects(68.4%).Futhermore,there were 376 subjects of Qi-deficiency,464 subjects of Yang-deficiency,139 subjects of Yin-deficiency,140 subjects of Phlegm-dampness,243 subjects of Dampheat,58 subjects of Stagnant Blood,178 subjects of Stagnant,33 subjects of Inherited Special.Balanced constitution group and unbalanced constitution group had significant difference on the life status,family history of mental illness,GAD-7 score and PHQ-9 score.In this study,balanced constitution group included 718 subjects(30.6%)and unbalanced constitution group included 1631 subjects(68.4%).Futhermore,there were 376 subjects of Qi-deficiency,464 subjects of Yang-deficiency,139 subjects of Yin-deficiency,140 subjects of Phlegm-dampness,243 subjects of Dampheat,58 subjects of Stagnant Blood,178 subjects of Stagnant Qi,33 subjects of Inherited Special.Balanced constitution group and unbalanced constitution group had significant difference on the life status,family history of mental illness,GAD-7 score and PHQ-9 score.Qi-deficiency was the mainly constitution of the anxiety group and the TCM constitution of anxiety group and non-anxiety group had significant differences inthe aspects of balanced constitution,Qi-deficiency,Yin-deficiency,Phlegm-dampness and Stagnant Qi.However,Qi-deficiency was also the mainly constitution of the depressive group and the TCM constitution of depressive group and non-depressive group had significant differences inthe aspects ofbalanced constitution,Qi-deficiency,Yin-deficiency,Stagnant Qi.Qi-deficiency was also the mainly constitution of the anxiety disorder group and the TCM constitution of anxiety disorder group and non-anxiety disorder group had significant differences inthe aspects of balanced constitution,Qi-deficiency,Stagnant Qi.The depression disorder was mainly constituted with Qi-deficiency.There are significant difference between the depression disorder group and non-depression disorder group in aspect of balanced constitution,Qi-deficiency,Yin-deficiency,Stagnant Blood,Stagnant Qi.Multivariate logistic regression analysis showed that balanced constitution was the protective factor of anxiety disorder andQi-deficiency and Stagnant Qi were the risk factors of anxiety disorder.Furthermore,the protective factor of depression disorder was also balanced constitution and the risk factors of anxiety disorder were Qi-deficency,Stagnant Blood and Stagnant Qi.Conclusion1.The outpatients of general hospitals are mainly unbalanced constitution,and the most frequent constitution were the Yang-deficency,Qi-deficency and dampness-heat.It reminded that the constitution character of the outpatients in general hospital were mainly the deficency,stagnant and dampness.2.There was a certain correlation between different constitution types and anxiety and depressive symptoms.The subjects with unbalanced constitution were more likely to appear anxiety and depressive symptoms.However,Qi-deficiency,Yin-deficiency,Phlegm-dampnessand Stagnant Qi were more likely to appear anxiety symptoms.But Qi-deficiency,Yin-deficiency and Stagnant-Qiwere more likely to appear depressive symptoms.3.The anxiety disorder and depression disorder were assosiate with different constitution types.The important pathogenic constitution of anxiety disorder were the Qi-deficency and Stagnant Qi but the Qi-deficency,Stagnant Blood and Stagnant Qi were the important pathogenic constitution.It remind that the constitution character of the anxiety and depression disorder were the deficency and stagnant.As result,the most important treatment principle of anxiety and were invigorating spleen and removing blood stasis in clinical practice.