女性抑郁症患者对抑郁严重程度的自我识别及其相关因素  

Self-recognition of depressive severity of woman patients with depression and its related factors

作　　者：王相兰[1,2] 韩自力[1] 洪春霞[3] 唐秀梅[1] 张晋碚[1] 

机构地区：[1]中山大学附属第三医院精神科,广州510630 [2]中南大学湘雅二医院精神卫生研究所 [3]中山大学附属第三医院感染科,广州510630

出　　处：《中华临床医师杂志（电子版）》2010年第11期52-56,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省医学科研基金(A2009199)

摘　　要：目的研究女性抑郁症患者对抑郁严重程度的自我评估和临床评估的差异及其相关因素。方法对68例女性抑郁症患者进行汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、症状自评量表(SCL-90)评估及一般资料调查。抑郁严重程度的临床评估依据HAMD总分分为轻度、中度和重度三级,自我评估依据SDS抑郁严重程度指数分为无抑郁、轻度、中度和重度四级,然后根据自我评估和临床评估的分布一致性将自我识别分为一致、低估和高估三级,分析三组患者一般资料和SCL-90因子分的差异。结果自我评估和临床评估不一致(K=-0.056,P=0.518),一致、低估和高估比例分别为23.5%、35.3%和41.2%;高估组SCL-90躯体化、强迫、敌对、焦虑、偏执等因子均分高于一致组(P<0.05);工作状态(r=-0.420,P=0.002)、精神疾病家族史(r=-0.310,P=0.026)及病程(r=0.276,P=0.042)和轻中度抑郁患者的自我识别相关。结论女性抑郁症患者自我识别的抑郁严重程度和临床评估的一致性差,全职工作、有精神疾病家族史者倾向于低估,而病程长,伴发躯体、强迫、焦虑等症状更明显者倾向于高估。Objective This study was aimed to investigate the self-recognition of severity of depressive symptoms in woman inpatients with depression and its related factors. Methods Zung＇ s Self-rating Depression Scale （ SDS） and the Hamilton Depression Scale （ HAMD） were used for assessment of self-rated and clinical assessment of depressive severity,respectively. According to the severity index of SDS,self-severity was classified into none,mild,moderate and severe levels. On basis of the total score of HAMD,clinician-severity was classified into mild,moderate and severe levels. Symptom Checklist-90 （ SCL-90） was used for evaluating clinical symptoms of patients. Self-recognition of depression severity was evaluated according to the agreement relationship between self and clinician assessment of depression severity,and was divided into agreement,under-estimating and over-estimating levels. General data and scores of SCL-90 subscales were compared among three groups with different self-recognition levels. Results Self-rated severity of depressive symptoms was not agree with that of clinician evaluating （ K = -0. 056,P = 0. 518）. Prevalence of agreement,under-estimating and over-estimating was 23. 5% ,35. 3% and 41. 2% correspondingly. Patients with over-estimating had higher mean scores of subscale of somatization,obsessive-compulsive,anger-hostility,anxiety and paranoid ideation than those with agreement estimating （ P 〈0. 05）. Occupation status （ r = -0. 420,P =0. 002） ,family history of mental illness （ r = -0. 310,P = 0. 026） and disease course （ r = 0. 276,P = 0. 042） were correlated to self-recognition of patients with mild-moderate depression severity. Conclusions Self-recognition of severity in woman inpatients withdepression is lack of accordance with clinician＇s assessment. Patients with fulltime work and family history of mental illness are likely to under-estimate depressive severity,but those with longer course of disease and more outstanding somatic,obsessive-compulsive an

关 键 词：情绪障碍 识别( 心理学) 抑郁 

分 类 号：R749.4[医药卫生—神经病学与精神病学]