伴精神病性症状的抑郁症患者与童年期虐待及血浆瘦素的相关性  

Correlation between major depression disorder with psychotic features and childhood abuse and plasma leptin

作　　者：汪卫华 刘羽 隋云川 纪菊英 周蓉 赵汉清 Wang Weihua;Liu Yu;Sui Yunchuan;Ji Juying;Zhou Rong;Zhao Hanqing(Mental Health Department,Psychiatric Center of PLA,the No.904 Hospital of PLA,Changzhou 213003,China)

机构地区：[1]解放军联勤保障部队第九○四医院全军精神医学中心心理科,常州213003

出　　处：《神经疾病与精神卫生》2021年第2期95-98,共4页Journal of Neuroscience and Mental Health

基　　金：全军医药卫生基金资助项目(14MS014)。

摘　　要：目的探讨抑郁症伴精神病性症状患者与童年期虐待及血浆瘦素的关系。方法选取符合条件的抑郁症患者150例,使用儿童受虐问卷(CTQ)、汉密尔顿抑郁量表-24(HAMD-24)、症状自评量表(SCL-90)评定儿童期受虐状况、抑郁严重程度及精神病性症状严重度;根据SCL-90评分将患者分为研究组(伴精神病性症状,56例)和对照组(不伴精神病性症状,94例)。采用酶联免疫吸附法测定血浆瘦素水平。结果(1)研究组的年龄[(35.4±14.1)岁比(41.8±12.4)岁;t=2.76,P=0.005]、首次发病年龄[25(20,36)岁比31(23,41)岁;Z=2.531,P=0.011]均小于对照组;研究组与对照组间父母之间各关系构成比差异有统计学意义(χ^(2)=10.78,P=0.010);研究组父母之间关系“感情差”的比例最高[44.6%(25/56)],而对照组“感情一般”的比例最高[51.1%(48/94)]。(2)两组的童年虐待总发生率[分别为48.2%(27/56)和29.8%(28/94)]及情感忽视发生率[分别为33.9%(19/56)和19.1%(18/94)]比较,差异均有统计学意义(均P<0.05)。两组中均以情感忽视最常见,其次为躯体忽视,而均以性虐待最少见。(3)研究组的血浆瘦素水平[(4.685±2.462)μg/L]低于对照组[(6.860±3.972)μg/L;P<0.001]。结论童年期虐待和低血浆瘦素水平可能是抑郁症伴精神病性症状患者发病的相关因素。Objective To explore the correlation of childhood abuse and plasma leptin in patients with major depression disorder with psychotic features.Methods A total of 150 eligible patients with major depression disorder were selected.The Childhood Trauma Questionnaire(CTQ),Hamilton Depression Rating Scale(HAMD-24)and Symptom Checklist 90(SCL-90)was used to assess the child abuse status,the severity of depression and the severity of psychotic symptoms.According to the SCL-90 score,the patients were divided into study group(56 cases with psychotic symptoms)and control group(94 cases without psychotic symptoms).The plasma leptin level was determined by enzyme-linked immunosorbent assay(ELISA).Results(1)The age and the age of first onset of the study group were both lower than those of the control group[(35.4±14.1)vs(41.8±12.4),t=2.76,P=0.005;25(20,36)vs 31(23,41),Z=2.531,P=0.011].The difference of the proportion of each relationship between parents was statistically significant(χ^(2)=10.78,P=0.010).The study group had the highest proportion of"emotionally poor"[44.6%(25/56)],while the control group had the highest proportion of"emotionally average"[51.1%(48/94)].(2)The total incidence of childhood abuse[48.2%(27/56)and 29.8%(28/94)]and the incidence of emotional neglect[33.9%(19/56)and 19.1%(18/94)]were significantly different between the two groups(all P<0.05).In both groups,emotional neglect was the most common,followed by physical neglect,and sexual abuse was the least common.(3)The plasma leptin level in the study group[(4.685±2.462)μg/L]was lower than that in the control group[(6.860±3.972)μg/L;P<0.001].Conclusions Childhood abuse and low plasma leptin level may be riskfactors of depression with psychotic symptoms.

关 键 词：抑郁症 虐待 瘦素 精神病性症状 相关性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]