Abstract: Background　Studies have shown that chronic diseases are closely related to psychological emotions.Most previous studies focused on the relationship between individual chronic diseases and anxiety and depression，and there is a lack of systematic research on the relationship between chronic disease burden and anxiety and depression in elderly patients.Objective　To explore the relationship between chronic disease burden and anxiety and depression in elderly patients.?Methods　From March to June in 2018，103 elderly patients were enrolled continuously from the Department of Geriatric Medicine in Tongji Hospital.Chronic disease burden was measured with Charlson Comorbidity Index （CCI）.CCI scores≤3 indicated low chronic disease burden.CCI scores>3 indicated high chronic disease burden.Anxiety was measured with the Generalized Anxiety Disorder-7 （GAD-7）.Depression was measured with the Patient Health Questionnaire-9 （PHQ-9）.The incidence of anxiety and depression in elderly patients with different degrees of chronic disease burden was compared.Results　The GAD-7 scores ranged from 0 to 21 with a mean of （3.7±4.8）.PHQ-9 scores ranged from 0 to 25 with a mean of （5.3±5.3）.The results of assessments showed that a total of 42 （40.8%） patients exhibited symptoms of depression；28 （27.2%） patients exhibited symptoms of anxiety；and 22 （21.4%） patients exhibited comorbid anxiety and depression.Low disease burden group had 54（52.4%）cases，while high disease burden group contained 49 （47.6%）cases.There was no significant difference of anxiety and depression in two groups （P>0.05）.There was no significant difference in the incidence of anxiety and depression between patients with different genders and age （P>0.05）.Conclusion　There is a high incidence of anxiety and depression in the elderly inpatients，so the medical staffs need to pay more attention to their mental health.In our study，no significant correlation was found between the disease burden of elderly inpatients and anxiety and depression，so we suspect that negative emotions have little impact on the elderly patients with multiple chronic diseases.

Key words: Chronic disease, Burden of illness, Anxiety, Depression, Charlson comorbidity index, Aged

摘要： 背景　有研究表明慢性病与心理情绪密切相关，既往研究多集中在单个慢性病与焦虑、抑郁关系的研究，而缺乏对老年患者慢性病负担综合系统的研究。目的　探究综合性医院老年慢性病住院患者疾病负担与焦虑、抑郁的关系。方法　收集2018年3—6月于同济大学附属同济医院老年科住院的患者103例，运用Charlson合并症指数（CCI）来量化疾病负担，CCI评分≤3分为低疾病负担组，CCI评分>3分为高疾病负担组，采用广泛性焦虑量表（GAD-7）评估焦虑症状，健康问卷抑郁症状群量表（PHQ-9）评估抑郁症状，比较不同程度疾病负担的老年患者焦虑、抑郁的发生率。结果　103例老年患者GAD-7评分0~21分，平均（3.7±4.8）分，伴焦虑者28例（27.2%）；PHQ-9评分0~25分，平均（5.3±5.3）分，伴抑郁者42例（40.8%），其中，合并焦虑及抑郁者22例（21.4%）。低疾病负担组54例（52.4%），高疾病负担组49例（47.6%）。低疾病负担与高疾病负担的老年患者焦虑、抑郁发生率比较，差异无统计学意义（P>0.05）。不同性别、年龄亚组两组老年患者焦虑、抑郁发生率比较，差异均无统计学意义（P>0.05）。结论　老年住院患者焦虑、抑郁发生率较高，但未发现老年住院患者高、低疾病负担在焦虑、抑郁情绪间存在明显差异，可能负性情绪对合并多种慢性病的高龄老年人群影响较小。

关键词: 慢性病, 疾病负担, 焦虑, 抑郁, Charlson合并症指数, 老年人