脑震荡患者不同阶段的抑郁症状表现

Characteristics of HAMD at Different Stages after Cerebral Concussion

目的观察脑震荡患者不同阶段的抑郁症状表现,探讨进行心理干预的可能性。方法77例脑震荡伤患者在急性期(发病后7d内)和恢复期(30d左右)分别接受汉密尔顿抑郁量表(HAMD)调查,并与48名正常人(对照组)的测试结果比较。结果脑震荡患者急性期焦虑躯体化、认知障碍、迟缓、睡眠障碍、绝望感等因子评分和HAMD总分均高于对照组(P<0.05)。恢复期中,前者的焦虑躯体化、体重变化、认知障碍、昼夜变化、迟缓、睡眠障碍、绝望感等全部因子评分和HAMD总分均高于对照组(P<0.05)。脑震荡患者急性期、恢复期大多数HAMD症状评分值均高于对照组;此外,恢复期脑震荡患者的抑郁情绪、自杀、入睡困难、早醒、激越、躯体性焦虑、全身症状、疑病、体重减轻、自知力、昼夜变化、绝望感和自卑感等症状评分值及HAMD总分也均高于急性期患者,而后者中的阻滞、精神性焦虑、人格或现实解体、偏执症状、强迫症状和能力减退感等症状评分值高于恢复期患者(P<0.05)。结论脑震荡患者发病后不同阶段抑郁症状表现是不完全相同的,心理干预应做到有针对性。

Objective To observe the manifestations of depression at different stages after cerebral concussion. Methods 77 cerebral concussion patients received Hamilton Depression Rating Scale （HAMD） examination at acute stage （in the 7 days after disease） and convalescence stage （at about 30 days after disease）, and then compared with 48 health adults. Results The scores of anxietas somatization, cognitive handicap, retardation, dyssomnia, feeling of despair conclude the total score in the cerebral concussion patients at acute stage were all significantly higher than that of the control （P 〈 0.05）. During the convalescence stage, the scores of anxietas somatization, the change of body weight, cognitive handicap, diurnal variation, retardation, dyssomnia, feeling of despair conclude the total score were all significantly higher than that of the control （P 〈 0.05）. The scores of almost all the item of HAMD were significantly higher than that of the control at both acute stage and convalescence stage, and the scores of athymia, suicide, difficulty falling asleep, early awake, agitate, somatization, constitutional symptom, hypoehondriasis, loss of weight, insight, diurnal variation, feeling of despair, anosognosia, sense of inferiority and total HAMD scores at convalescence stage were all significantly higher than that at the acute stage, but the scores of blockage, psychoanxietas, derealization, symptom of over-absorption mind, compel symptom, sense of capability decrease at the acute stage were all significantly higher than that at the convalescence stage （P 〈 0.05）. Conclusion The manifestations of depression in the cerebral concussion patients were not completely the same, so the mental intervention should be in direction.