影响老年抑郁症疗效的多因素分析

A multiple factors analysis on the effect in elderly depressive patients

目的探讨影响老年抑郁症疗效的有关因素。方法以标准化评定工具对 12 2例老年抑郁症疗效进行评定 ,分析影响老年抑郁症疗效的有关因素。结果 12 2例的老年抑郁症疗效差者占 3 2 .8% ,疗效好者 67.2 % ;经单因素分析 ,两组间在以下因素存在明显差异 :病前适应状况差、病前负性生活事件、社会支持差、发病年龄早、发病次数多、病程长、双相抑郁、伴有精神病性症状、伴有躯体疾病、既往自杀史、精神病家族史、起病形式、既往治疗不当、治疗依从性差、脑电图异常等。经多元逐步回归分析 ,影响老年抑郁症疗效的主要因素依次为 :治疗依从性差、合并精神病性症状、既往治疗不恰当、双相抑郁和社会支持差。结论老年抑郁症的疗效和预后受生物、心理、社会等多种因素的影响 ,应全面干预。

ObjectiveTo explore the influencing factors of curative effect in elderly depressive patients. Methods122 cases of elderly depressive patients who met CCMD-3 criterion were assessed with standard scales such as GAS, SOS and LES. The related factors which affected treatment outcomes were analyzed. Results40 cases( 32.8%)of elderly depressive patients have poor curative effect ,and between the two groups there were significant difference in these factors such as poor premorbid adjustment, the negative life events ,poor social support, early-onset, recurrent, long durations, bipolar depression , with psychotic symptoms, with somatic disorders, history of suicide ,family history, onset situation, improper treatment, poor compliance ,abnormal EEG results. Through multivariate analyses of stepwise regression, we found that some factors , such as poor compliance , with psychotic symptoms, improper treatment, bipolar depression and poor social supports entering the equation. ConclusionThe curative effect of elderly depressive patients was associated with bio-psycho-social factors, which should be intervented completely.