抑郁障碍与人格障碍的共病研究

Comorbidity of depressive disorders and personality disorders

目的 了解抑郁障碍患者中人格障碍的发生率,探讨抑郁障碍与人格障碍的共病情况。方法 使用SCID- Ⅱ对102例抑郁障碍患者进行人格障碍的评估,并与102例正常人群对照,对抑郁障碍组进行汉密尔顿抑郁量表(HAMD)评定。结果 抑郁障碍组人格障碍的发生率为51.9%,31.4%的患者被诊断为两种或以上的人格障碍,显著高于对照组的14.7%;女性抑郁障碍患者人格障碍的发生率(63.5%)显著多于男性患者(40.0%);重性抑郁症与心境恶劣患者人格障碍的共病率则无统计学差异(P>0.05);抑郁障碍患者中最常见的人格障碍类型为回避型、强迫型、消极型以及偏执型。结论 抑郁障碍患者中具有较高的人格障碍患病率,对抑郁障碍和人格障碍的共病应引起临床高度重视。

Objective To explore the prevalence rate of comorbid personality disorders in patients with depressive disorders and the differences in comorbid pathology, demographic and clinical characteristics between patients with depression and those with dysthymic disorder.Methods One hundred and two depressive patients and 102 normal people were recruited into the investigation and diagnosed by structured clinical interview for DSM-IV. The patients were also evaluated using Hamilton rating scale for depression.Results Fifty-one point nine percent of the depressive patients were diagnosed as personality disorder, 31.4% were diagnosed as at least two personality disorders, and that in normal people was 14.7%. The prevalence rate of comorbidity in female depressive patients was significantly higher than that in male depressive patients (63.5% versus 40.0%). No significant difference on prevalence rate of comorbidity between patients with depression and those with dysthymic disorder was found. Avoidant personality disorder, obsessive-compulsive personality disorder, passive personality disorder and paranoid personality disorder were much common in depressive patients.Conclusion Personality disorders were much common in depressive patients. Clinicians should be aware of comorbidity of depressive disorders and personality disorders.