老年抑郁症的心理社会因素研究

Psychosocial Factors of Depression in Late Life

目的 :探讨老年抑郁症的心理社会因素。方法 :按CCMD -3心境障碍抑郁发作诊断标准 ,收集 3 3例 60岁以上首次发作的患者 (抑郁组 ) ,3 2名健康老年人 (对照组 )。采用生活事件量表、艾森克问卷、简易智力状态检查表和社会支持评定量表等 ,进行测评分析。结果 :抑郁组与对照组精神疾病家族史 (分别为 5例 /0例 ,χ2 =5 2 5 3 ,P =0 0 2 2 )、现患躯体疾病 ( 16例 /6例 ,χ2 =6 415 ,P =0 0 11)、血管危险因素 ( 10例 /3例 ,χ2 =4 44 7,P =0 0 3 5 )和长期困境 ( 19例 /3例 ,χ2 =14 43 7,P =0 0 0 0 )的差异有显著性 ,而抑郁组MMSE总分 2 6 2± 2 3低于对照组 2 7 3± 0 8(t =2 5 5 2 ,P =0 0 15 )。抑郁组负性生活事件分值 17 9± 15 0低于对照组 10 7± 7 8(t =2 42 ,P =0 0 19) ;抑郁组社交问题分值 3 5± 6 9高于对照组 1 2± 3 8(u =1 982 ,P =0 0 47)。抑郁组社会支持总分 3 9 5± 6 8低于对照组 42 9± 4 2 (t =2 43 4,P =0 0 18) ;抑郁组对支持的利用度 5 9± 2 7低于对照组 8 4± 1 6(u =3 844 ,P =0 0 0 0 )。抑郁组神经质分 60 0± 8 8高于对照组 5 1 7± 4 9(t =4 73 7,P =0 0 0 0 ) ;抑郁组与对照组的神经质个性 ( 2 4例 /3例 ,χ2 =2 6 85 1,P =0 0 0 0 )

Objective:To explore psychosocial factors of depressed elderly patients. Methods:33 elderly people with the first episode of depression diagnosed according to CCMD-3, and elderly healthy people were investigated with EPQ, SSRS (social support rating scale), LES (life event scale) and MMSE (mini mental state examination). Results:The rates of psychiatric family history, somatic diseases, risk factors for vascular disease and long-term difficulties were significantly higher in the depressive group than in control group. The score of MMSE was significantly lower in depressive group than in control group. The scores of negative life events and problems in social intercourse were significantly higher in depressive group than in control group. There were lower score of social support and its utility in the depressive group than in control group. The score of neuroticism was significantly higher in the depressive group. Most depressive elderly patients had the personality of neuroticism.Conclusion:Chronic stress, high neuroticism and severe cognitive impairment are important risk factors for depression in late life.[