老年卒中后抑郁与非抑郁患者人格特征分析

Personality analysis on elderly patients with or without post-stroke depression

目的调查卒中后抑郁的影响因素、临床结局及采用明尼苏达多相人格测验研究老年卒中后抑郁患者的心理特征。方法对160例老年卒中患者进行回顾性病例对照研究,根据有无卒中后抑郁分为2组,采用logistic回归分析卒中后抑郁的影响因素,并统计分析卒中后抑郁患者的人格特征。结果抑郁人格、疑病人格、精神衰弱人格量表分值差异显著(P<0.05);疑病分值、抑郁分值与老年卒中后抑郁呈正相关;配偶支持、卒中部位、简易智能评分量表分值和美国国立卫生研究院卒中评分量表分值与老年卒中后抑郁发生相关。老年卒中后抑郁组卒中后30 d Bathel生活能力评分比对照组显著降低(P<0.05),30 dRankin评分0-1级抑郁组人数显著减少(P<0.001)。结论老年卒中后抑郁患者人格以抑郁人格、疑病人格、精神衰弱人格为主;缺乏配偶支持、前循环病变、认知障碍和卒中严重的患者更易发生老年卒中后抑郁;老年卒中后抑郁的发生延长平均住院时间、影响卒中的临床康复。

Objective To examine the risk factors and outcome of post-stoke depression（PSD）and to analyze the personality of the elderly PSD patients using Minnesota Multiphasic Personality Inventory.Methods A total of 160 elderly PSD patients were analyzed retrospectively.The risk factors were analyzed using logistic regression analysis.The personality of the elderly PSD patients was also assessed.Results The scores on personalities of suspicion and depression were significantly different between PSD and non-PSD cases（P0.05）,which were positively Correlated with PSD in the elderly cases.Spouse support,PSD sites,mini-mental status examination,and National Institutes of Health stroke scale were associated with PSD in the elderly.Rankin score and Bathel index between PSD and non-PSD patients were significantly different（P0.05）.Conclusion The personalities of suspicion and depression are predominant in the elderly PSD patients.No spouse support,lesion of anterior circulation,cognitive disorder,and severe stoke are risk factors for PSD in the elderly cases.PSD in the elderly cases postpones hospitalization duration and predicts worse clinical outcome.