心身障碍的识别与治疗黛力新亢万虎 ppt课件

和不良行为模式。(徐俊冕等1983)Adapted from: WPA/PTD Educational Program on Depressive Disorders. Gavard JA, et al. Diabetes Care. 1993;16(8):1167-1178.躯体疾病与抑郁障碍共病的发生率5.8%一般人群9.4%慢性疾病33%住院病人36%老年住院病人33%癌症门诊病人42%癌症住院病人47%脑中风45%心肌梗塞39%帕金森病0%10%20%30%40%50%神经系统疾病中的抑郁问题抑郁和焦虑障碍与躯体疾病的共病抑郁和焦虑障碍与躯体疾病的共病糖尿病糖尿病::??有明显抑郁情绪者为有明显抑郁情绪者为29%,29%,有明显焦虑情绪者有明显焦虑情绪者为为32%32%??抑郁、焦虑情绪与糖代谢指标的变化有密切抑郁、焦虑情绪与糖代谢指标的变化有密切关系关系??自杀危险性明显增加自杀危险性明显增加抑郁和焦虑障碍与躯体疾病的共病抑郁和焦虑障碍与躯体疾病的共病功能性胃肠疾病功能性胃肠疾病患者伴发抑郁比例高患者伴发抑郁比例高1. Walker EA et al. Irritable bowel syndrome and psychiatric illness. Am J Psychiatry 1940;147:565-572.2. Clouse RE et al. Psychiatric illness and contraction abnormalities of the esophagus. N Eng J Med 1983;309:1337-1342.3. Clouse RE et al. Aeiment Phonmacol Ther. 1994;8:409.抑郁1肠易激综合征(IBS)患者功能性食道病患者功能性消化不良(FD)患者50%抑郁252%抑郁352%