卒中后抑郁患者心理社会影响因素的对照研究  

The controlled study on psychosocial factors for post-stroke depression

作　　者：康岚[1,2,3] 王希林[1,2,3] 刘粹[1,2,3] 廖金敏[1,2,3] 黄成兵[4] 黄悦勤[1,2,3] 孙丽君[1,2,3] 谷朝霞[1,2,3] 

机构地区：[1]北京大学第六医院 [2]北京大学精神卫生研究所 [3]卫生部精神卫生学重点实验室(北京大学),北京100191 [4]江苏省淮安市第三人民医院

出　　处：《中国神经精神疾病杂志》2014年第6期357-361,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家科技支撑计划项目(编号:2009BAI77B06)

摘　　要：目的：探讨卒中后抑郁（post-stroke depression，PSD）的主要心理社会影响因素。方法应用复合性国际诊断问卷-3.0中文版对405例住院脑卒中患者进行筛查与诊断，其中符合抑郁障碍诊断标准的22例患者为抑郁组，在383例无抑郁障碍的患者中按性别、年龄匹配原则以1：2比例抽取44例作为非抑郁组。采用生活事件量表、简易应对方式问卷、社会支持评定量表、日常生活活动能力量表和简明幸福与生活质量满意度问卷对两组进行测评。结果抑郁组的简易应对方式问卷中消极应对维度分高于非抑郁组[（1.2±0.5） vs.（0.8±0.7）]，抑郁组的社会支持评定量表中主观支持分低于非抑郁组[（17.5±4.0） vs.（20.7±4.6）]，差异均有统计学意义（均P＜0.05）。Logis-tic回归分析显示，少数民族（OR=2.564，95%CI：1.039～6.327）和消极应对（OR=2.223，95%CI：1.052～5.192）是PSD的危险因素，主观支持是PSD的保护因素（OR=0.884，95%CI：0.793～0.986）。结论消极应对方式和主观社会支持不足可能是PSD重要的心理社会因素。Objective To investigate psychosocial factors for post-stroke depression （PSD）. Methods 405 in-pa-tients with stroke were first screened for depression using Comprehensive International Diagnostic Interview-3.0. 22 pa-tients with depression were recruited as the depression group. From 383 patients without depression, 44 patients were se-lected and served as the non depression controlled group according to the sex and age paired with 1：2. Both groups were measured by using questionnaires including Life Event Scale, Simplified Coping Style Questionnaire, Social Support Rat-ing Scale, Activities of Daily Living Scale and Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form. Re-sults The score of passive coping was significantly higher in depression group than in non depression group [（1.2 ± 0.5） vs. （0.8±0.7）, P〈0.05]. The score of subjective support was significantly lower in depression group than in non depression group [（17.5±4.0） vs. （20.7±4.6）, P〈0.05]. Logistic regression analysis showed, minority nationality （OR=2.564, 95%CI：1.039～6.327） and passive coping style （OR=2.223, 95%CI：1.052～5.192） were risk factors for PSD, while subjective sup-port was protective factor for PSD （OR=0.884, 95%CI：0.793～0.986）. Conclusions Passive coping style and low subjec-tive support may be the important psychosocial factors of PSD.

关 键 词：卒中后抑郁 心理社会因素 应对方式 社会支持 

分 类 号：R749.13[医药卫生—神经病学与精神病学]