抑郁症患者急性期治疗后残留症状对生活质量满意度的影响  

Effect of residual symptoms on satisfaction with quality of life in patients with depression after acute treatment

作　　者：任小丹[1] 朱雪泉[1] 冯媛[1] Ren Xiaodan;Zhu Xuequan;Feng Yuan(National Center for Psychological and Mental Diseases Clinical Medical Research,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院、国家精神心理疾病临床医学研究中心,100088

出　　处：《神经疾病与精神卫生》2023年第4期252-257,共6页Journal of Neuroscience and Mental Health

基　　金：北京市卫生健康委员会高层次公共卫生技术人才培养计划(学科骨干-1-028)。

摘　　要：目的 探讨抑郁症患者急性期治疗后残留症状对生活质量满意度的影响。方法 于2016年5月至2017年10月,选取我国16家精神专科医院或综合医院精神心理科已完成8~12周急性期抗抑郁药物治疗的428例门诊抑郁症患者为研究对象,开展为期6个月的随访调查。采用抑郁症状快速评估量表(QIDS-SR_(16))、简明幸福与生活质量满意度问卷(Q-LES-Q-SF)评估患者的残留症状及生活质量满意度。根据QIDS-SR_(16)总分将患者分为症状完全缓解组(QIDS-SR_(16)≤5分)和残留症状组(QIDS-SR_(16)>5分),两组于第1、3、6个月末完成随访并进行组间比较。采用广义线性估计方程分析两组患者的生活满意度在随访期间的变化。结果 428例患者中,完全缓解组患者179例(41.8%),残留症状组患者249例(58.2%)。除睡眠太多外,基线期完全缓解组患者与残留症状组患者的残留症状比较,差异有统计学意义(P<0.01)。完全缓解组患者的生活满意度高于残留症状组,差异有统计学意义(Z=-5.57,P<0.01)。广义线性估计方程分析结果显示,随访期两组Q-LES-Q-SF总分较基线期升高,时间效应显著(Z=2.50~3.98,P<0.05)。单因素分析结果显示,入睡困难、睡眠不深、早醒、感觉沮丧、食欲/体重改变、注意力受损、消极的自我评价、自杀观念、投入感缺乏、精力丧失、反应迟钝和坐立不安对患者生活满意度存在影响(Z=-8.75~0.72;P<0.05)。多因素分析显示,QIDS-SR_(16)中的自杀观念、投入感缺乏、精力丧失、反应迟钝是抑郁症患者的生活满意度的影响因素(Z=4.03、2.00、3.26、2.26;P<0.05)。结论 急性期治疗残留症状越明显,对患者的生活质量满意度造成的不良影响越大。Objective To discuss the effects of residual symptoms after acute phase treatment on satisfaction with quality of life in Chinese patients with depression.Methods From May 2016 to October 2017,a total of 428 outpatients with depression who had completed 8-12 weeks'acute antidepression treatment were recruited from 16 hospitals.A 6-month follow-up survey was conducted.Brief 16-Item Quick Inventory of Depressive Symptomatology Self-Report(QIDS-SR_(16)),Quality of Life Enjoyment and Satisfaction Questionnaire Short Form(Q-LES-Q-SF)were used to assess the residual symptoms and the satisfaction with quality of life.According to QIDS-SR_(16) scores,the participants were divided into complete remission group(QIDS-SR_(16) scores≤5)and residual symptom group(QIDS-SR_(16) scores>5),followup was conducted at the end of 1 month,3 months and 6 months,and the effects of residual symptoms on patients'life satisfaction were evaluated.Generalized linear estimation equations were applied to analyze the changes in life satisfaction between two groups of patients.Results Of the 428 patients,179 patients(41.8%)were in the complete remission group and 249 patients(58.2%)were in the residual symptoms group.At baseline,except for too much sleep,there were statistically significant differences in residual symptoms between patients in the complete remission group and those in the residual symptom group(P<0.01).Patients in the complete remission group had higher life satisfaction than the residual symptom group,with a statistically significant difference(Z=-5.57,P<0.01).The results of the generalized linear estimating equation analysis showed that the total Q-LES-Q-SF scores were higher in both groups during the followup period compared with the baseline period,with a significant time effect(Z=2.50-3.98,P<0.05).The results of univariate analysis showed that difficulty falling asleep,poor sleep,early awakening,feeling depressed,appetite/weight change,impaired concentration,negative self-evaluation,suicidal ideation,lack of engagement,loss

关 键 词：抑郁症 残留症状 生活质量 满意度 

分 类 号：R749.4[医药卫生—神经病学与精神病学]