双重抑郁症与抑郁症临床特征的研究  

The clinical features of double depression and major depressive disorder

作　　者：严保平[1] 崔利军[1] 孙秀丽[1] 刘永桥[1] 李建峰[1] 韩彦超[1] 栗克清[1] 江琴普[1] 高良会[1] 杨老虎[1] 

机构地区：[1]河北省精神卫生中心精神科,保定071000

出　　处：《中华精神科杂志》2012年第3期145-149,共5页Chinese Journal of Psychiatry

摘　　要：目的了解双重抑郁症与抑郁症患者的临床特征。方法采用随机多级抽样方法，以美国精神障碍诊断与统计手册第4版．修订版（DSM-Ⅳ-TR）为诊断标准，以DSM-1V-TR轴Ⅰ障碍定式临床检查患者版为诊断工具，以河北省流行病学调查的399例抑郁症患者为研究对象，其中符合双重抑郁症诊断标准患者56例（双重抑郁症组），符合抑郁症诊断标准患者343例（单一抑郁症组）；采用功能大体评定量表（GAF）评定患者的功能状况。结果399例抑郁症患者中，双重抑郁症的检出率为14．04％。单一抑郁症组和双重抑郁症组均有较高的其他精神障碍的共病率，分别为39．94％和48．21％，2组比较差异无统计学意义（X^2=1．361，P〉0．05）；均以共病未特定的焦虑障碍、特殊恐怖症、广泛性焦虑障碍、创伤后应激障碍、惊恐障碍、酒依赖／酒滥用等常见。双重抑郁症组患者精神运动性激越、优柔寡断、自杀未遂症状出现的频率均高于单一抑郁症组（P〈0．05），2组均以忧郁特征为常见临床特征（〉50％）。2组GAF评分和疾病的严重程度比较差异无统计学意义（t=0．354，P〉0．05；X^2=0．655，P〉0．05）。结论抑郁症中双重抑郁症的比例不低，共病其他精神障碍均较常见，但双重抑郁症患者自杀的风险更高，做事情总是优柔寡断。Objective To investigate the clinical features of double depression and major depressive disorder. Methods Using the multistage random sampling method and the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder Fourth edition （ DSM-Ⅳ ） was used as diagnostic criteria and the Structured Clinical Interview for DSM-Ⅳ-TR Axis Ⅰ Disorders-Patient Edition （ SCID- Ⅰ / P） was used as diagnostic tools. In 399 cases with major depressive disorder, 56 subjects were with double depression. The Global Assessment Functions （GAF） was used to evaluate the functional status. Result Both single and double depression groups had high comorbidity incidence of other mental disorders （39. 94% ,48.21% ） , and there was no significant difference on the comorbidity rate between the two groups （ X^2 = 1. 361, P 〉 0. 05 ）. Unspecified anxiety disorder, special phobia, generalized anxiety disorder and posttraumatic stress disorder, alcohol-related disorder were common comorbidity diseases in the two groups. There was a significant difference on the psychomotor agitation, indecision, suicide attempts symptom between patients with double depression and ones with single depression, and the former was more than the later （P 〈 0. 05）. The melancholy was the common clinical characteristic in the two groups. There was no significant difference on the GAF score and the severity of disease between the two groups （ P 〉 0. 05 ）. Conclusion The results indicate the proportion of double depression is not low in patients with major depressive disorder, and patients with double depression may have higher risk of suicide and do things always indecisive.

关 键 词：抑郁症 更年期 流行病学方法 共病现象 

分 类 号：R749.4[医药卫生—神经病学与精神病学]