双相情感障碍抑郁发作患者人格特质与无抽搐电休克疗效的关系探讨  

Relationship between personality traits and the curative effect of the MECT in patients with depressive episode in bipolar disorder

作　　者：张彦华 吕琳 高超 Zhang Yanhua;Lv Lin;Gao Chao(The Fourth People's Hospital of Nanyang,Nanyang 453000,Henan,China)

机构地区：[1]南阳市第四人民医院,河南南阳453000

出　　处：《临床心身疾病杂志》2025年第1期12-17,共6页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20200901)。

摘　　要：目的探讨双相情感障碍抑郁发作患者人格特质与无抽搐电休克疗效的关系。方法将139例双相情感障碍抑郁发作患者、145例单相重度抑郁障碍患者、136名健康人群分别设为双相抑郁组、单相抑郁组、对照组。采用艾森克人格问卷简式量表中国版(EPQ-RSC)评估三组受试者人格特质。双相抑郁组、单相抑郁组患者均采取无抽搐电休克治疗,根据临床疗效进一步分为总有效患者与无效患者,分析双相情感障碍抑郁发作患者无抽搐电休克疗效的影响因素,评估人格特质对其疗效的预测价值。结果双相抑郁组与单相抑郁组受试者EPQ-RSC精神质、神经质分量表评分高于对照组(P<0.01),双相抑郁组受试者神经质、内外向性分量表评分高于单相抑郁组、对照组(P<0.01),单相抑郁组受试者内外向性分量表评分低于对照组(P<0.01)。双相抑郁组中治疗无效患者EPQ-RSC精神质、神经质分量表评分高于总有效患者(P<0.01);双相抑郁组总有效患者EPQ-RSC内外向性分量表评分高于单相抑郁组(P<0.01)。多因素Logistic回归分析显示,EPQ-RSC的精神质、神经质分量表评分高是双相情感障碍抑郁发作患者无抽搐电休克治疗无效的危险因素(P<0.05);受试者工作特征(ROC)曲线分析显示,EPQ-RSC的精神质、神经质分量表评分联合预测双相情感障碍抑郁发作患者无抽搐电休克治疗无效的曲线下面积(AUC)高于各项单独预测(P<0.05)。结论双相情感障碍抑郁发作患者具有高精神质、高神经质、外向性的人格特质,且高精神质、高神经质可增加无抽搐电休克治疗无效的风险,并对无抽搐电休克疗效具有较好的预测价值,可为临床治疗提供指导。Objective To explore the relationship between personality traits and the curative effect of modified electroconvulsive therapy(MECT)in patients with depressive episode in bipolar disorder(BD).Methods A total of 139 BD patients with depressive episode were set as bipolar depression group,145 ones with unipolar major depression as unipolar depression and 136 healthy persons as control,respectively.Personality traits were assessed for subjects of 3 groups using the Eysenck Personality Questionnaire-Revised Short Scale For Chinese(EPQ-RSC).Patients of both bipolar and unipolar depression group received the MECT and were further divided into total effective and ineffective ones,factors influencing the curative effect of the MECT in BD ones with depressive episode analyzed,and predictive values of personality traits for the curative effect.Results The psychoticism(P)and neuroticism(N)scores of the EPQ-RSC were higher in both bipolar and unipolar depression than control group(P<0.01),so were N,introversion and extraversion in bipolar depression than unipolar depression and control group(P<0.01),and introversion and extraversion were lower in unipolar depression than control group(P<0.01).The P and N score of the EPQ-RSC were higher in ineffective than total effective patients in bipolar depression group(P<0.01),so were introversion and extraversion in total effective ones in bipolar depression than unipolar depression group(P<0.01).Multivariate Logistic regression analysis showed that the P and N score of the EPQ-RSC were risk factors for MECT failure in patients with depressive episode of the BD(P<0.05).The analysis of receiver operating characteristic(ROC)curve showed that the area under the ROC curve of combined P and N score predicting MECT failure in patients with depressive episode of the BD was higher compared with separate prediction(P<0.05).Conclusion Patients with depressive episode of the BD have personality traits of high P,high N and extrovertion,high P and N may increase the risk of MECT failure and have b

关 键 词：双相情感障碍 抑郁 人格特质 无抽搐电休克治疗 

分 类 号：R749.4[医药卫生—神经病学与精神病学]