首诊抑郁症2年转归及影响因素  

TWO-YEAR OUTCOME AFTER A FIRST-VISIT DIAGNOSIS OF DEPRESSION AND ITS INFLUENCING FACTORS

作　　者：赵鑫[1] 徐勇[2] 于建华[2] 

机构地区：[1]青岛大学医学院医学心理学与精神病学教研室,山东青岛266003 [2]青岛市精神卫生中心

出　　处：《齐鲁医学杂志》2014年第2期137-138,141,共3页Medical Journal of Qilu

摘　　要：目的探讨抑郁症诊断、转归及其影响因素。方法对111例抑郁症病人首次诊断、病程1年及病程2年临床资料进行回顾性分析,结合其住院记录和病程记录,根据CCMD-3诊断标准进行再诊断,并应用汉密尔顿抑郁量表(HAMD)进行评分。结果病程1年时,维持抑郁症诊断者83例(74.8%),转归为双相障碍者25例(22.5%),转归为精神分裂症、分裂情感类障碍、分离转换性障碍者各1例(分别占0.1%)。病程2年时,维持抑郁症诊断者75例(67.6%),转归为双相障碍者29例(26.1%),其余诊断未改变。发病年龄、家族史及诱发因素是抑郁症向双相障碍转归的显著影响因子。结论抑郁症在2年病程内多转归为双相障碍,发病年龄、家族史、诱发因素可以预测其转归为双相障碍。Objective To investigate the diagnosis of depression, its shifts and related influencing factors. Methods Clinical data of 111 patients with first-admission diagnosis of depression, the clinical course being one totwo years, were analyzed retrospectively. Combining their hospitalization records and progress notes, a re-diagnosis was made according to CCMD-3 diagnostic criteria and scored using Hamilton depression scale （HAMD）. Results At year 1,83 patients （74.8%） kept the original diagnosis, 25 （22.5%） shifted to bipolar disorder, and those who shifted to schizophrenia, schizoaffective disorder and dissociative disorder were noted in one （0.1%）, respectively. At year 2,75 （67.6%） remained the original diagnosis as having depression, and 29（26.1%） of them the diagnosis was shifted to bipolar disorder. Age of onset, family history and causative factors were significantly contributing factors to shift the condition from depression to bipolar disorder. Conclusion Depression mostly shifts to bipolar disorder within two years of clinical course, and age of onset, family history and causative factors may predict the outcomes.

关 键 词：抑郁症 双相情感障碍 诊断 

分 类 号：R749.4[医药卫生—神经病学与精神病学]