单相抑郁与双相抑郁障碍患者临床资料和发病特点的对比研究  

A comparative study of clinical data and characteristics of unipolar depression and bipolar depression

作　　者：王佩蓉[1] 杨春玉[1] 连中 

机构地区：[1]浙江省立同德医院闲林院区精神科,杭州市311122

出　　处：《中华全科医学》2014年第4期513-515,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2011RCA007)

摘　　要：目的对比分析单相抑郁与双相抑郁障碍患者临床资料和发病特点，为其临床诊治提供数据支撑。方法回顾性分析浙江省立同德医院收治的60例双相抑郁患者（双相组）和180例单相抑郁患者（单相组），对患者基本临床资料、汉密尔顿量表（HAMD、HAMA）及认知功能做对比分析。所有结果经统计软件SPSS16．0处理，2组临床资料以率表示，行x2检验；2组患者汉密尔顿量表、认知功能比较行t检验。结果双相组患者的起病年龄显著低于单相复发性抑郁症（x2=5．163，P=0．023），家族遗传率、精神运动迟滞率及心境不稳定率显著高于单相组（x2=4．659～4．943，P=0．031—0．026）。2组患者HAMD和HAMA总得分差异无统计学意义，但HAMA部分单项得分因子有所差异，双相组患者的认知障碍和阻滞因子显著高于单相组（t1=57．76，P1=0．000；t：=11．61，P2=0．000），自杀行为显著低于单相组（t=82．13，P=0．000）。此外，在认知功能方面，双相组患者在韦氏测试再认得分及威斯康星卡片测试方面，均显著差于单相组（t=2．674—8．957，P=0．035～0．000）。结论单相抑郁和双相抑郁患者临床特征和发病特点有所不同，这些显著性差异可作为诊断双相抑郁症的潜在依据。Objective To discuss the difference in clinical data and characteristics between unipolar and bipolar depres- sion, so as to provide data basis for the diagnosis and treatment. Methods All 60 cases of patients with bipolar and 180 cases of patients with unipolar depression were retrospectively analyzed. The clinical data, Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） and cognitive ability were compared between the two groups. The chi- square test was used to compare the difference of clinical data, and t test was used to analyze the difference in Hamilton Scale and cognitive function. The statistical analysis was clone by SPSS 16.0. Results The age of onset in the bipolar de- pression group was significantly lower than that in the unipolar depression group （X2 = 5. 163,P = 0.023 ） , but the rate of familial heredity rate, psychomotor retardation and mood instability in the bipolar depression group was significantly higher than that of the unipolar depression group （ X2 = 4. 659, P = 0. 031, X2 = 4. 943, P = 0. 026 ）. There was no statistical difference in the total score of HAMD and HAMA（ P 〉 0.05 ） , but difference existed in some HAMA factors. The rate of cognitive impairment and retardation factor in the bipolar depression group was significantly higher than that in the unipo- lar depression group（ t = 57.76,P = 0. 000 and t = 11.61, P = 0. 000） , but the rate of suicidal behavior was significantly lower（ t = 82.13,P = 0. 000）. In addition, for cognitive function, the recognition scores by Wechsler test and score by Wis- consin Card Sorting Test in the bipolar depression group were significantly worse than those in the unipolar depression group （ P 〈 0.05 or P 〈 0. 001 ）. Conclusion There is difference in clinical data and characteristics between unipolar and bipolar depression, which can be used as a potential foundation for diagnosis and treatment of bipolar depression.

关 键 词：单相抑郁 双相抑郁 临床资料 发病特点 

分 类 号：R749.41[医药卫生—神经病学与精神病学]