摘要
目的 探讨抑郁障碍与其他精神障碍的共患率及其对抑郁障碍患者的影响。方法经美国精神障碍诊断与统计手册第4版轴Ⅰ障碍用定式临床检查-临床版评定,对符合抑郁障碍诊断的366例患者评定汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和临床疗效总评量表病情严重程度(CGI SI)。结果 (1)38 2%的抑郁症患者当前至少共患焦虑障碍、心境恶劣障碍、物质使用障碍、躯体形式障碍和饮食障碍等5种障碍中的1种。其中焦虑障碍共患率最高(26 5%, 97例),其次为心境恶劣障碍(13 4%, 49例),均高于共患其他3种障碍(P<0 01);而其他3种障碍共患率之间的差异无统计学意义。( 2 )共患焦虑障碍和心境恶劣障碍者的HAMD分别为( 29 25±6 22)分和(30 15±6 15 )分,HAMA分别为( 22 01±5 61 )分和( 20 36±5 36 )分,CGI SI分别为(5 32±0 99)分和(4 76±1 12)分,均高于无共患者[分别为( 26 02±6 06 )分, ( 16 76±5 26 )分,(4 02±1 08)分;均P<0 01]。( 3 )共患焦虑障碍和心境恶劣障碍的抑郁症患者中分别有84%和82%的患者期望治疗共患障碍。结论 抑郁障碍常共患焦虑障碍和心境恶劣障碍;其焦虑抑郁症状更严重,更期望治疗所共患的障碍。
Objective To explore the frequency of diagnostic comorbidity in major depressed patients and the effect of comorbid disorders on the patients.Methods Three hundred and sixty-six patients with 4th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ) major depressive disorder were evaluated with a clinician version of the Structured Clinical Interview for DSM-Ⅳ axisⅠdisorders. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to assess the depressive and general anxiety symptoms, and the Clinical Global Impression (CGI) for severity of illness.Results At the time of the evaluation, 38.2% of the patients met criteria for at least 1 of the 5 AxisⅠdisorders, in which anxiety disorders were the most frequently comorbid disorders, and dysthymic disorder the second (all P<0.01). The prevalence rates of substance use disorders, somatoform disorders and eating disorders were not different with each other (P>0.05). Depressed patients with anxiety disorders or dysthymic disorders, but not those with substance use disorders or somatoform disorders, had significantly higher scores on the HAMD, HAMA and CGI than those without comorbidity (P<0.01). Most of the patients had the wishes that anxiety disorders and dysthymic disorder be treated.Conclusions The patients with major depressive disorders often have a current comorbid anxiety disorder, and the comorbid anxiety disorders and dysthymic disorder appear to affect symptom severity negatively, for which most patients may seek treatment.
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2005年第2期98-100,共3页
Chinese Journal of Psychiatry
基金
深圳市科技局三项基金资助项目(199805040)
