两种自评问卷筛查综合医院诊断抑郁障碍患者的既往躁狂症状  

Screening reported mania symptoms by two self-rating questionnaires from outpatients with depressive disorders in a general hospital

作　　者：张旭[1] 陆峥[1] 吴文源[1] 崔海松[1] 刘美兰[1] 姚军[1] 郭珍[1] 李清伟[1] 

机构地区：[1]同济大学医学院附属同济医院精神医学科,上海200065

出　　处：《中华行为医学与脑科学杂志》2011年第7期658-661,共4页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：科技部支撑项目（2009BA177805）

摘　　要：目的探索两种躁狂症状问卷在综合医院门诊ICD-10诊断的抑郁障碍是否筛查出既往有躁狂症状，及两个问卷识别躁狂症状的差异及其与临床特征的关系。方法连续评估同济大学附属同济医院精神科门诊符合ICD-10诊断的抑郁障碍102例，调查工具包括自编问卷、中文版心境障碍调查问卷（Chinese version mood disorder questionnaire，CV—MDQ）、中文版32项轻躁狂症状清单（Chinese version 32 iterns hypomania check list，CV—HCL-32），CV—MDQ≥7分为既往躁狂症状阳性，CV—HCL-32≥14分为既往轻躁狂症状阳性。结果1．内部一致性检验显示，CV—MDQ的Cronbach’sα值为0．808，P〈0．01，CV—HCL-32的Cronbachgα值为0．916，P〈0．01。2．11例患者（10．8％）在CV—MDQ报告躁狂症状阳性，14例（13．7％）在CV—HCL-32报告躁狂症状阳性，两问卷判别躁狂或轻躁狂的一致性有显著差异（Kappa=0．227，P〈0．05）。3．CV—HCL-32阳性组的首发年龄、总病程、本次病程、复发次数的中位数（35．0岁，60．0月，12．0月，2．5次）与阴性组（50．5岁，22．0月，6．0月，1．0次）差异具有显著性（Z=-2．065，-2．102，-2．180，-2．168，均P〈0．05），年龄、性别、文化程度差异无显著性（P〉0．05）；CV—MDQ阳性组与阴性组间差异无显著性（P〉0．05）。结论CV—MDQ和CV—HCL-32可在综合医院门诊ICD诊断为抑郁障碍患者中检出一定比例既往有躁狂或轻躁狂症状，但CV—HCL-32是否较CV—MDQ更适用于筛查双相Ⅱ型障碍值得探索。Objective To explore the prevalence of self reported mania/hypomania symptoms of depressive disorders and the difference between the two self-rating symptoms questionnaires in setting of psychiatric clinic of a general hospital. Methods 102 outpatients who were diagnosed with depressive disorders by ICD-10 in department of psychiatry of Tongji Hospital of Tongji University were continuously investigated and fulfilled the Chinese Version mood disorder questionnaire（CV-MDQ） and the Chinese Version 32 items hypomauia check list（ CV- HCL-32）. The positive mania symptoms were elevated with at least seven positive mania items reported by the CV- MDQ. The positive hypomania symptoms were elevated with at least fourteen positive hypomania items reported by the CV-HCL-32. Results The internal consistency（ Cronbach alpha） of the CV-MDQ was 0. 808 （95% CI = 0. 767 - 0. 845, P 〈 0.01 ）. The internal consistency（ Cronbaeh alpha） of the CV-HCL-32 was 0. 916 （95% CI = 0. 898 - 0. 930, P 〈 0.01 ）. 11 patients （ 10.8% ） reported positive mania symptoms by the CV-MDQ. 14 patients （ 13.7% ） had been reported positive hypomania symptoms through the CV-HCL-32. The ability of discriminating mania or hypomania between the two scales was significantly different （ Kappa = 0. 227, P 〈 0.05 ）. Compared to the patients who were reported negative hypomania symptoms by the CV-HCL-32, the 11 patients with positive hypomania symptoms by the CV-HCL-32 had much earlier age in first episode （35.0 vs 50.5, z = - 2. 065, P 〈 0.05 ） ,much longer months in total disease course（60.0 vs 22.0, z = - 2. 102, P 〈 0.05 ） and present episode （12.0 vs 6.0, z= -2. 180, P〈0.05） , and much higher frequency of relapse（2.5 vs 1.0, z= -2. 168, P〈 0.05 ） , but no significant differences at age, gender and education. No significant differences appeared between CV-MDQ positive and negative group. Conclusion Mania or hypomania symptoms may be screened by CV-MDQ and CV-HCL-32 from the outpatients with dep

关 键 词：心境障碍 综合医院 中文版心境障碍调查问卷 中文版32项轻躁狂症状清单 

分 类 号：R749.4[医药卫生—神经病学与精神病学]