神经症与抑郁症的躯体化症状及经济损失比较

A comparative study of neurosis and depression with somatic symptoms and economic burdens

目的:比较神经症和抑郁症躯体症状的特点及经济损失。方法:对初次就诊的神经症和抑郁症患者,采用自编躯体症状的特点及经济负担调查问卷,调查躯体症状及经济损失状况。结果:二者躯体症状所占的比例差异无显著性,神经症组的病程显著长于抑郁症组,外院就诊次数也多于后组,从其他科至医学心理科就诊的时间间隔长。抑郁症组汉密尔顿焦虑量表(HAMA)精神焦虑因子分、汉密尔顿抑郁量表(HAMD)总分、体质量、认知障碍、日夜变化、阻滞、绝望感因子分均高于神经症组,焦虑/躯体化因子分低于神经症组。躯体症状组HAMA总分及躯体焦虑因子分、HAMD总分、焦虑/躯体化、体质量、睡眠障碍、绝望感因子分均高于无躯体症状组。神经症组的直接经济损失重于抑郁症组。结论:抑郁症、神经症的抑郁、焦虑、躯体症状的表现有各自特点,躯体症状会加重抑郁和焦虑症状,均造成很大的经济负担。

Objective： To explore the characteristics of somatic symptoms and economic burdens of neurosis and depression. Method： Neurosis and depressive patients, who were treated in medical psychology for the first time, were interviewed and evaluated with the survey of features and economic burdens of somatic symptoms to study the somatic symptoms and economic burdens. Results：The proportions in the neurosis and depressive groups with somatic symptoms had no significant difference. The former duration was obviously longer than the latters＇ and the times, which neurosis patients went to see doctors were more than depressive patients. The time from the other administrative offices to the medical psychological office in neurosis group was of long duration. The psychological anxious element＇s score in Hamilton anxiety scale （HAMA）, the total score, the weight, cognition obstruction, day and nights variation, slow in thought and action and despair feeling element＇s score in Hamilton depressive scale （HAMD） of the depressive group were higher than the neurosis group. But the anxious or somatization element＇s score of the depressive group was lower. The total score and the body anxious element＇s score in HAMA, the total score, the anxious or somatization, weight, sleep obstruction and despair feeling element＇s score in HAMD of the group with somatic symptoms were higher than the group without the somatic symptoms. The direct economic burdens of the neurosis group were more than the depressive group. Conclusion：The manifests of the characteristics of depression, anxiety and the somatic symptoms are different in neurosis and depression. The somatic symptoms would aggravate the symptoms of depression and anxiety. Meanwhile, they give rise to much more economic burdens.