摘要： 我國(guó)人口老齡化進(jìn)程的加速致使慢性病共病問(wèn)題愈發(fā)突出，這不僅給醫(yī)療體系帶來(lái)沉重負(fù)擔(dān)，也對(duì)患者身心健康構(gòu)成嚴(yán)重威脅。老年慢性病共病患者因多病共存更易出現(xiàn)焦慮、抑郁等心理問(wèn)題，癥狀檢出率明顯高于無(wú)病或患單一慢性病人群。盡管發(fā)病機(jī)制尚不明確，但人口學(xué)（年齡、性別、教育程度）、社會(huì)經(jīng)濟(jì)（家庭收入、居住地）、社會(huì)支持、健康狀況和生活方式等因素均與心理健康密切相關(guān)，明確這些因素對(duì)制定精準(zhǔn)干預(yù)策略至關(guān)重要?，F(xiàn)有老年慢性病共病患者心理健康干預(yù)措施分為藥物與非藥物兩類。藥物治療雖能緩解癥狀，但多藥聯(lián)用風(fēng)險(xiǎn)限制了其應(yīng)用。而非藥物干預(yù)通過(guò)多元化手段展現(xiàn)獨(dú)特優(yōu)勢(shì)：團(tuán)體心理干預(yù)強(qiáng)化社會(huì)支持網(wǎng)絡(luò)，認(rèn)知行為療法修正負(fù)性認(rèn)知，運(yùn)動(dòng)療法改善軀體與心理雙重健康，音樂(lè)/懷舊/敘事療法調(diào)節(jié)情緒狀態(tài)，“互聯(lián)網(wǎng)+”技術(shù)突破時(shí)空限制提升干預(yù)可及性，中醫(yī)療法實(shí)現(xiàn)身心同治，健康教育聯(lián)合心理護(hù)理通過(guò)知識(shí)賦能增強(qiáng)自我管理能力。這些措施已被證實(shí)能有效提升共病患者心理健康水平。本綜述聚焦老年慢性病共病患者的流行病學(xué)、影響因素及干預(yù)策略，為心理健康促進(jìn)提供依據(jù)。未來(lái)需深化多病交互機(jī)制研究，構(gòu)建基于風(fēng)險(xiǎn)評(píng)估的個(gè)性化干預(yù)體系，并通過(guò)多中心長(zhǎng)期隨訪驗(yàn)證干預(yù)效果，以助力健康老齡化目標(biāo)的實(shí)現(xiàn)。

關(guān)鍵詞: 慢性病共病, 老年人, 焦慮, 抑郁, 影響因素分析, 心理干預(yù), 綜述

Abstract: The accelerated aging of China's population has contributed to the increasing prominence of chronic disease comorbidities，significantly increasing the medical burden and threatening patients' physical and mental health. Elderly patients with chronic disease comorbidities are more likely to have psychological problems such as anxiety and depression due to multiple comorbidities，and their symptom detection rate is significantly higher than that of the healthy or single chronic disease population. Although the pathogenesis is unclear，demographic（age，gender，education），socioeconomic（household income，place of residence），social support，health status，and lifestyle factors are strongly associated with mental health，and elucidation of these factors is essential for the development of precise intervention strategies. Existing interventions are classified as both pharmacological and non-pharmacological. Although medications provide symptomatic relief，the risk of polypharmacy limits how they're used. Non-pharmacological interventions show unique advantages through diversified means：group psychological intervention strengthens the social support network，cognitive behavioral therapy corrects negative cognition，exercise therapy improves both physical and psychological health，music/nostalgia/narrative therapy regulates emotional states，Internet+ technology breaks through time and space constraints to increase accessibility of interventions，traditional Chinese medicine therapy realizes physical and mental co-treatment，and health education and co-psychological care enhance self-management ability through knowledge and empowerment. These interventions have been shown to be effective in improving the mental health of comorbid patients. This article reviews national and international studies focusing on the epidemiology，influencing factors，and intervention strategies of elderly multimorbid patients to provide a basis for mental health promotion. In the future，it is necessary to deepen research on the mechanism of multidisease interaction，establish a personalized intervention system based on risk assessment，and verify the effect of intervention through multicenter long-term follow-up，in order to achieve the goal of healthy aging.

Key words: Multiple chronic conditions, Aged, Anxiety, Depression, Root cause analysis, Psychological interventions, Review

中圖分類號(hào): 

R 339.34　R 749.72　R 749.42　

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