综合医院神经内科专病门诊抑郁状态患者的特点  

Clinical characteristics of patients with depressive disorders at Department of Neurology in general hospitals

作　　者：吴恒趋[1] 张瑛[1] 李焰生[1] 朱莹[1] 沈沸[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,200127

出　　处：《中华医学杂志》2010年第25期1760-1763,共4页National Medical Journal of China

摘　　要：目的 分析综合医院神经内科专病门诊患者抑郁状态的临床特点.方法 对2005年10月至2009年2月在上海交通大学附属仁济医院失眠与神经症专病门诊就诊患者进行连续性前瞻性登记,收集人口学等资料、评估26项躯体症状、应用Hamilton抑郁量表（HDRS17）进行评分并采用病例对照方法分析抑郁状态患者的临床特点.结果 596例患者中,抑郁状态347例（58.1%）,汉密尔顿抑郁量表（HDRS-17）平均分数为21.9±3.4,以轻、中度抑郁为主.抑郁患者情感症状诉说率低,情绪低落146例（41.2%）、兴趣减退161例（46.4%）,有2项症状者108例（31.3%）;体力劳动者、受教育程度低下、婚姻状况差、经济状况差、不规律的生活方式、既往有躯体疾病者易出现抑郁;抑郁组患者常见躯体症状依次为早醒218例（76.0%）、入睡困难254例（73.2%）、记忆力差219例（63.1%）、疲乏无力181例（52.2%）、心悸179例（51.6%）、头晕170例（49.0%）、头痛160例（46.1%）、胸闷140例（40.3%）;平均主诉的躯体症状个数为（6.9±2.8）个;具有多个躯体症状主诉者（躯体症状主诉≥4个）为322例（92.8%）;相关分析显示躯体症状个数与抑郁相关.结论 综合医院神经内科专病门诊抑郁状态患者躯体症状突出.Objective To evaluate the clinical characteristics of patients with depressive disorders at Department of Neurology in general hospitals.Methods A total of 596 consecutive patients with depressive symptoms,such as insomnia,or somatic symptoms were collected prospectively and those who were unable to answer the questionnaire were excluded.Data of demography and clinical characteristics were obtained from a questionnaire.The 17-item Hamilton depression rating scale （HDRS17） was used to identify the presence of depressive disorders. Case control method was employed to evaluate the clinical characteristics of patients with depressive disorders.Results Among all pailents,347 were diagnosed as depressive disorders （58.1%）.The mean score of HDRS17 was 21.9±3.4.Fewer psychological symptoms were complained by patients with depressive disorder.The depressive mood was found in 146（41.2%）,a loss of interost or pleasure 161 （46.4%） and depressive mood plus a loss of interest or pleasure 108 （31.3%）.The factors of manual worker.lower education level.worse marital status.10wer economic statos,irregular lifestyle and coexisting medical conditions were associated with depressive disorders.The most frequent complaints of somatic symptoms were as follows：hard to fall asleep 254 （73.2%）,early awakening 218（76.O%）,poor memoory 219 （63.1%）,fatigue 181（52.2%）,palpitation 179（51.6%）,dizziness 170（49.0%）,headache 160（46.1%） and dyspnea 140 （40.3%）.The mean number of somatic symptoms wag 6.87±2.78.The patients complaining of multiple somatic symptoms （≥4） was 322 （92.8%）.The number of somatic symptoms was correlated with depressive disorders.Conclusions More minor depression and sonlatic symptoms are the main characteristics of patients with depressive disorder in general hospitals.

关 键 词：医院 综合 抑郁 临床特征 

分 类 号：R749.2[医药卫生—神经病学与精神病学]