老年抑郁症和焦虑障碍共病患者的临床特征

Comorbidity of Anxiety and Depression in Geriatric Patients

目的探讨老年抑郁症和焦虑障碍共病患者的临床特征。方法根据美国精神障碍诊断手册第四版(DSM-IV)的诊断标准,把78例老年抑郁症患者分为两组,单纯抑郁症组(抑郁症组,N=44)及抑郁症和焦虑障碍共病组(共病组N=34)。对所有对象评定一般人口学资料及老年抑郁量表(GDS)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、简易智能状态评定量表(MMSE)和健康状况调查问卷(SF-36)等,比较两组患者间差异。结果抑郁症组与共病组患者的性别、年龄、病程、居住情况、家族史、民族、发病诱因和受教育年限等方面的差异无统计学意义(均P>0.05)。GDS总分(14.0±1.2/12.1±2.0,t=4.92)、HAMD(38.1±4.0/33.4±4.7,t=4.35)和HAMA总分(22.6±5.5/11.7±2.7,t=10.93)及其因子分、HAMD第3项(自杀)条目分、SF-36躯体功能(79.2±13.6/69.1±13.6,t=3.25)、社交功能(70.0±21.2/50.0±22.5,t=4.02)评分共病组均高于抑郁症组差异有统计学意义(均P<0.05)。结论老年抑郁症和焦虑障碍共病患者较单纯抑郁患者的抑郁和焦虑症状更重、自杀风险大、生活质量更差。

Objective： The aim of the study is to explore the clinical feature of depressed elderlypatients. Methods： Seventy-eight geriatric depression patients diagnosed according to DSM-IV were divided to pure depression （ depression group, N = 44 ） and comorbidity anxiety and depression group （ comorbidity group, N = 34 ） .All patients were investigated with HAMD, HAMA, SF-36, GDS and MMSE. Results： Compare the rates of psychiatric family history, life thing and sex, age, education year, living eonditiont nation and course of disease, the twogroup were not significantly different （P 〉0. 05 ） . The score of HAMD （38.1 ±4.0/33.4± 4.7, t = 4. 35 ）, HA-MA （22. 6±5.5/11.7±2. 7, t = 10. 93）, GDS （ 14.0±1.2/12. 1±2.0, t =4. 92） of eomorbidity group was significantly higher than that of the depression group. The social function （SF） （ 70. 0±21.2/50. 0±22. 5, t =4. 02 ）and physical function （PF） （79. 2 ±13.6/69. 1 ±13.6, t =3. 25） scores of SF-36 were significantly higher in depressive group than in comorbidity group. Conclusion： Comorbid depression and anxiety and anxious depression areassociated with more severe overall psychopathology than nonanxious depression in elderly persons, similar to observations in younger adults.