有精神病性症状老年期抑郁症临床分析  

Clinical characteristics of patients with first onset depression with psychotic symptoms in the elderly

作　　者：胡艳琼[1] 肖世富[2] 李冠军[2] 周晓琴[1] 

机构地区：[1]安徽省合肥市第四人民医院心身医学科,230022 [2]上海交通大学医学院附属精神卫生中心,上海200030

出　　处：《蚌埠医学院学报》2010年第6期599-601,共3页Journal of Bengbu Medical College

摘　　要：目的:分析有精神病性症状老年期抑郁症患者的临床特征。方法:将109例老年期抑郁症首发患者根据是否存在精神病性症状分为有精神病性症状组(A组)15例和无精神病性症状组(B组)94例,并对临床资料进行比较分析。结果:A组自杀行为发生率为53.3%,显著高于B组的24.5%,差异有统计学意义(P<0.05),自杀行为的相对危险度为3.53。妄想内容以罪恶妄想40.0%、被害妄想13.3%、疑病妄想6.7%为多见,其中伴有幻听40.0%;A组联合抗精神病药物治疗为20.0%,高于B组的2.1%(P=0.018)。两组近期治疗效果差异无统计学意义(P>0.05)。结论:首发老年期抑郁症是否伴有精神病性症状者,在自杀行为、治疗方法上存在差异。Objective：To assess the clinical characteristics of elderly patients with first onset depression with psychotic symptoms.Methods：One hundred and nine elderly patients with first onset depression were divided into group A（with psychotic symptoms,n=15） and group B（without psychotic symptoms,n=94）,and the clinical characteristics were compared between them.Results：The suicide rate in group A was 53.3%,which was significantly higher than that in group B（24.5%）.The difference was significant（P0.05）.The suicidal behavior was significantly related to delusion（RR=3.53）.The most common psychotic symptoms were delusions of guilty（40.0%）,persecution（13.3%）and hypochondriasis（6.7%）,and 40.0% of the patients were accompanied with auditory hallucinations.There were significant differences in treatment with antipsychotics and antidepressants between the two groups（P=0.018）.No significant difference was observed in recent efficacy between the two groups（P0.05）.Conclusions：Suicidal behavior is more common in elderly depression patients with psychotic symptoms,and antidepressants combined with antipsychotics should be applied to those with psychotic symptoms.

关 键 词：抑郁症 老年精神病学 精神病性症状 临床特征 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]