儿童期虐待、催乳素对首发青少年抑郁障碍患者抑郁症状的影响  

Effects of childhood maltreatment and prolactin on depressive symptoms in adolescents with first-episode depressive disorder

作　　者：段登艾 王海明[1] 陆香秀 张轶杰[1] 邱尔仙 DUAN Deng’ai;WANG Haiming;LU Xiangxiu(Yunnan Provincial Psychiatric Hospital,Kunming 650224,China)

机构地区：[1]云南省精神病医院,云南昆明650224

出　　处：《精神医学杂志》2023年第1期26-30,共5页Journal of Psychiatry

基　　金：昆明市卫生健康委员会卫生科研课题项目(编号:2022-03-09-018);云南省精神病医院项目(编号:省精科研2022-09)。

摘　　要：目的探索不同类型儿童期虐待及不同浓度泌乳素水平的首发青少年抑郁障碍患者抑郁症状的差异性。方法选取136例首次发作且未曾用药的青少年抑郁障碍患者,采用汉密尔顿抑郁量表(HAMD)、儿童期虐待问卷(CTQ)及测量催乳素(PRL)水平,进行横断面调查。结果与不存在情感虐待的青少年抑郁障碍患者相比较,存在情感虐待HAMD认知障碍、迟缓、绝望感因子分更高(P<0.05);与不存在躯体虐待的青少年抑郁障碍患者相比较,存在躯体虐待HAMD体重、认知障碍因子分更高(P<0.05);与不存在性虐待的青少年抑郁障碍患者相比较,存在性虐待HAMD认知障碍、绝望感因子分更高(P<0.05);与不存在躯体忽视的青少年抑郁障碍患者相比较,存在躯体忽视HAMD焦虑/躯体化症状、体重因子分更高(P<0.05);与不存在情感忽视的青少年抑郁障碍患者相比较,存在情感忽视患者HAMD认知障碍、睡眠障碍、绝望感因子分更高(P<0.05)。与正常催乳素的青少年抑郁障碍患者相比较,高催乳素HAMD认知障碍、迟缓、绝望感因子分更高(P<0.01)。相关分析结果显示,HAMD总分与PRL水平、儿童期虐待总分均呈正相关(P<0.01);回归分析结果显示,PRL水平、儿童期虐待总分对HAMD总分有正向影响(P<0.01)。结论催乳素水平高或经历儿童期虐待的首发青少年抑郁障碍患者,其抑郁严重程度越高。Objective To explore the differences in depressive symptoms among adolescents with first-episode depressive disorder with different types of childhood maltreatment and prolactin levels.Methods A total of 136 adolescents with untreated first-episode depressive disorder were selected and assessed with Hamilton Depression Scale(HAMD),Childhood Trauma Questionnaire(CTQ),and their prolactin levels were measured to conduct a cross-sectional survey.Results The adolescents with emotional abuse showed higher factor scores of cognitive impairment,retard and despair of HAMD than the adolescents without emotional abuse(P<0.05).The adolescents with physical abuse showed higher factor scores of body weight,cognitive impairment of HAMD than the adolescents without physical abuse(P<0.05).The adolescents with sexual abuse showed higher factor scores of cognitive impairment and despair of HAMD than the adolescents without sexual abuse(P<0.05).The adolescents with physical neglect showed higher factor scores of anxiety/somatization,body weight of HAMD than the adolescents without physical neglect(P<0.05).The adolescents with emotional neglect showed higher factor scores of cognitive impairment,sleep disorder and despair of HAMD than the adolescents without emotional neglect(P<0.05).The adolescents with higher prolactin levels shower higher factor scores of cognitive impairment,retard and despair of HAMD than the adolescents with normal prolactin levels(P<0.01).The correlation analysis suggested that the total score of HAMD was positively associated with prolactin level and the total score of CTQ(P<0.01).The regression analysis showed that the prolactin level and the total score of CTQ may influence the total HAMD score positively(P<0.01).Conclusion Adolescents with first-episode depressive disorder with higher prolactin levels or childhood maltreatment tend to show more severe depressive symptoms.

关 键 词：青少年 首发抑郁障碍 抑郁症状 儿童期虐待 催乳素 

分 类 号：R749.94[医药卫生—神经病学与精神病学]