双相障碍患者出院后抑郁症状程度的关联因素  

Associated factors of post-discharge depressive symptom severity in patients with bipolar disorder

作　　者：储文革 盛旋莲 张婷婷[2] 赵来田 刘肇瑞[2] 陈燕 黄俊捷 胡凤领 王帅 徐小红 黄悦勤[2] CHU Wenge;SHENG Xuanlian;ZHANG Tingting;ZHAO Laitian;LIU Zhaorui;CHEN Yan;HUANG Junjie;HU Fengling;WANG Shuai;XU Xiaohong;HUANG Yueqin(Tongling Third People′s Hospital,Tongling 244000,Anhui Province,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100083,China)

机构地区：[1]铜陵市第三人民医院,安徽铜陵244000 [2]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083

出　　处：《中国心理卫生杂志》2025年第5期392-397,共6页Chinese Mental Health Journal

基　　金：安徽省卫生健康科研项目(AHWJ2022b118)。

摘　　要：目的:探讨双相障碍患者出院后抑郁症状严重程度的关联因素。方法:对符合DSM-5双相障碍诊断标准的住院患者进行出院后追踪调查,采用自编人口学、临床和社会功能等信息收集调查表收集患者的相关信息,临床特征评估由精神科医师面对面访谈完成,采用汉密顿抑郁量表(HAMD)评估患者的抑郁状态,简明精神病量表(BPRS)评估患者的病情严重程度和症状表现。以单因素分析和多重线性回归分析双相障碍患者出院后抑郁状态及其严重程度的关联因素。结果:共追踪出院的298例双相障碍患者。追踪调查时合并精神病性症状(标化回归系数β=0.18)、家务劳动(β=0.23)、社会人际交往(β=0.17)、BPRS总分(β=0.46)与HAMD总分正关联;生产劳动及工作(β=-0.27)、个人生活料理(β=-0.15)与HAMD总分负关联。结论:双相障碍患者出院后抑郁症状严重程度受多种因素影响。对于双相障碍患者出院后有效控制精神病性症状,在社区加强社会功能康复,有利于减少复发,获得良好的预后。Objective:To explore associated factors of post-discharge depressive symptom severity in patients with bipolar disorder.Methods:A longitudinal follow-up was conducted to investigate the demographic,behavioral,and clinical characteristics,and social function among discharged patients with bipolar disorder who met the DSM-5 diagnostic criteria.Clinical characteristics were assessed with the Hamilton Depression Scale(HAMD)and Brief Psychiatric Rating Scale(BPRS).Single factor and multivariate regression were carried out to explore the associated factors of depressive symptom severity in patients with bipolar disorder.Results:A total of 298 discharged patients with bipolar disorder were face-to-face interviewed to complete the follow-up survey.At follow-up time,psychotic symptoms(standardizedβ=0.18),housework(β=0.23),social interaction(β=0.17)and BPRS total score(β=0.46)were positively associated with HAMD total score.Productive labor and work(β=-0.27)and personal life management(β=-0.15)were negatively associated with HAMD total scores.Conclusion:Post-discharge depressive symptom severity in bipolar disorder patients is influenced by multiple factors.Effective management of psychotic symptoms,combined with enhanced community-based social rehabilitation and functional recovery,may help reduce the persistence or worsening of depressive symptoms and improve prognosis.

关 键 词：双相障碍 抑郁症状 关联因素 汉密顿抑郁量表 

分 类 号：R749.4[医药卫生—神经病学与精神病学]