应用轻躁狂检测清单甄别抑郁症中可能存在的双相障碍  

The Hypomania Check List-32 in distinguishing potential patients with bipolar disorder among depression patients

作　　者：马永春[1] 陈正昕[1] 金卫东[1] 邱德胜[2] 罗小年[3] 袁勇贵[4] 范学胜[5] 宋梓祥 

机构地区：[1]浙江省立同德医院心身科,杭州310012 [2]武汉大学人民医院精神科 [3]首都医科大学附属北京安定医院 [4]南京医科大学附属脑科医院 [5]中国医科大学精神卫生医院 [6]全军精神卫生中心精神科

出　　处：《中华精神科杂志》2010年第4期221-224,共4页Chinese Journal of Psychiatry

摘　　要：目的 通过轻躁狂检测清单（HCL-32）测评结果甄别抑郁症中可能存在的双相障碍.方法 对128例抑郁症患者应用软双相建议性诊断标准进行诊断,并比较软双相与非软双相抑郁症患者HCL-32的差异.结果 （1）128例抑郁症患者中,HCL-32评分0～19（5.7±4.7）分;（2）是否软双相抑郁者分别为15例和113例,HCL-32评分分别为[（9.4±6.7）分vs（5.2±4.2）分,t=3.40,P=0.001],是否宽松软双相抑郁者HCL-32评分分别为[（7.8±5.6）分vs（4.3±3.4）分,t=4.34,P=0.000],有无双相障碍家族史者HCL-32评分分别为[（9.2±6.8）分vs（5.4±4.4）分,t=2.39,P=0.018],有无躁狂转相史者HCL-32评分分别为[（8.6±7.3）分vs（5.3±4.3）分,t=2.05,P=0.043],有无环性人格或明显外向者HCL-32评分分别为[（8.4±5.7）分vs（5.3±4.4）分,t=2.58,P=0.011],有无旺盛性人格素质者HCL-32评分分别为[（9.0±6.7）分vs（5.0±3.9）分,t=3.90,P=0.000],有无边缘性人格者HCL-32评分分别为[（8.6±4.3）分vs（5.4±4.7）分,t=2.22,P=0.028],是否呈发作性病程者HCL-32评分分别为[（8.9±5.7）分vs（5.2±4.3）分,t=3.19,P=0.002];（3）男女患者HCL-32评分分别为[（4.3±3.7）分vs（6.6±5.1）分,t=2.87,P=0.005];（4）有抑郁症家族史者、有自杀家族史者、发病年龄≤25岁者、有非典型抑郁者、有精神运动抑制者、有精神病性抑郁者、有生物节律明显者HCL-32评分与对应组的差异无统计学意义;（5）HCL-32＞7分37例（28.9%）,＞10分17例（13.3%）,＞14分7例（5.5%）,其中＞10分者所占比例与软双相所占比例接近.结论 HCL-32＞10分可能有助于在抑郁症患者中筛选诊断双相障碍.Objective To assess results of the Hypomania Check List-32 （HCL-32） in Chinese depression patients for discriminating possible bipolar depression. Methods Totally 128 patients with depression meeting diagnostic criteria of depression in CCMD-3 and DSM-Ⅳ was assessed with the HCL-32,and their general data also was collected （gender, age, age of first onset, duration, family history,personality and type of temperament, and psychopathology）. And patients also were assessed with Chinese Advice Diagnostic Criteria of Soft Bipolar （CADCSB） and loose CADCSB （ Depression with family history of bipolar disorder, or depression with extra personality or hyperthymia or cyclothymia）. Results The mean score of the HCL-32 in this samples was （5.7 ±4.7） with range of 19（highest）to 0. There were higher HCL-32 scores in 15 soft bipolar than 113 no-soft bipolar patients （9.4 ±6.7,5.2 ±4.2,t =3.40,P=0.001）, in 50 loose CADCSB than 78 no-loose CADCSB patients （7.8 ±5.6,4.3 ±3.4,t =4.34,P =0.000） ,and in 9 depressive patients with bipolar family history （ 9.2 ± 6.8,5.4 ± 4.4, t = 2.39,P = 0.018 ）, 9 depressive patients with switching history （ 8.6 ± 7.3,5.3 ± 4.3, t = 2.05, P = 0.043 ）,17 depressive patients with cyclothymia or extra personality （ 8.4 ± 5.7,5.3 ± 4.4, t = 2.58, P = 0.011 ）,22 depressive patients with hyperthymia （ 9.0 ± 6.7,5.0 ± 3.9, t = 3.90, P = 0.000 ）, 11 depressive patients with borderline personality disorder（8.6 ±4.3,5.4 ±4.7,t =2.22,P =0.028）, 17 depressive patients with intermittent episode （8.9 ±5.7,5.2 ±4.3 ,t =3.19,P =0.002） than their respective controls. The HCL-32 of male patients was significantly higher than that of female patients （ 4.3 ± 3.7,6.6 ± 5.1, t = 2.87,P =0.005 ）. There was no difference in HCL-32 scores between patients with and without depression family history, patients with and without suicide family history, and ones with younger first onset age than older 25 years old, ones with and without atypical depr

关 键 词：抑郁症 双相情感障碍 轻躁狂检测清单 

分 类 号：R686[医药卫生—骨科学]