痴呆伴发抑郁症状的临床研究

Clinical study on the depressive symptoms in demented patients

目的 了解痴呆伴发抑郁症状的发生率及评估方法的适用性。方法 用单盲交叉设计 ,由不同职称的临床医生分别采用Hamilton抑郁量表 (HAMD)和老年抑郁量表 (GDS)对 36例符合《中国精神疾病分类方案与诊断标准》(CCMD 2 R)痴呆患者的抑郁症状进行评估。结果 HAMD评分为(18.80± 11.13) ,抑郁症状发生率为 4 1.7% ;GDS评分为 (12 .6 0± 5 .96 ) ,抑郁症状发生率为 36 .1%。HAMD条目中较常见的有能力减退 2 6例 (72 % )、精神性焦虑 2 3例 (6 4 % )、有罪感 19例 (5 3% )、抑郁 17例 (4 7% )、睡眠障碍 17例 (4 7% )。逐步多元回归分析表明 ,影响抑郁症状评定的因素有病情严重程度、病人受教育程度和GDS。结论 痴呆伴发抑郁症状较常见 ,评估时应注意患者的病情、教育程度。

Objective: To investigate the incidence of depressive symptoms in demented patients and the appropriateness of two rating scales. Methods: 36 cases of dementia were enrolled in the study and their depressive symptoms were measured with Hamilton Depression Rating Scale (HAMD) and The Geriatric Depression Scale (GDS). Results: The mean total HAMD score was (18.80±11.13) with the incidence of depression 41.7%, and the mean total GDS score was (12.60±5.96) with the incidence of depression 36.1%. The rating of depression was influenced by severity of dementia, patients' level of education and GDS. Conclusion: Depressive symptoms are common in demented patients and HAMD is a good tool to evaluate these symptoms.