症状自评量表焦虑与抑郁分比值对焦虑症和抑郁症诊断价值的探讨

A study of the possibility of diagnosis and differential diagnosis between anxiety disorder and depression disorder from clinical symptoms

目的探讨通过症状自评量表测验结果诊断和鉴别焦虑症与抑郁症的可能性。方法对首诊的抑郁症和焦虑症患者，采用症状自评量表（SCL-90）比较各组间评分的差异。结果焦虑组除了躯体化因子外，其他各因子分明显低于抑郁组[躯体化（2．12±0．28）分，（2．24±0．82）分；强迫（2．21±0．84）分，（2．64±0．81）分；人际关系敏感（1．78±0．72）分，（2．28±0．81）分；抑郁（2．14±0．82）分，（2．83±0．87）分；焦虑（2．26±0．85）分，（2．62±0．84）分；敌对（1．90±0．78）分，（2．26±0．82）分；恐怖（1．67±0．71）分，（2．01±0．76）分；偏执（1．68±0．78）分，（1．99±0．79）分；精神病性（1．88±0．71）分，（2．19±0．77）分]，差异有非常显著性（P〈0．01）；焦虑组与抑郁组焦虑／抑郁比值的对照有显著性差异，根据焦虑／抑郁比值大于1或小于1再分组，比较SCL-90评分情况：焦虑组中比值大于1组SCL-90中除了抑郁分较比值小于1组明显升高以外（P=0．01），其余各因子分结果比较，差异无显著性俨〉0．05）；抑郁组比值大于1组中躯体化、焦虑分较比值小于1组明显升高（P〈0．01），而人际敏感、抑郁分较比值小于1组明显降低（P〈0．05）。结论抑郁症患者焦虑等症状严重程度较焦虑症患者重，仅凭症状的绝对严重程度无法区别焦虑症和抑郁症患者，焦虑和抑郁的相对严重程度（焦虑／抑郁比值）可以作为诊断和鉴别的参考。

Objective To explore the possibility of diagnosis and differential diagnosis between anxiety disorder and depression disorder through the rating result of SCL-90. Methods 182 outpatients meet with the criteria of CCMD-Ⅲ for anxiety （ n =90） and depression （n=92） were assessed by SCL-90 to compare the two groups of the patient Result All the factors of SCL-90 except somatic were significantly higher in the group of depression than that of anxiety group, but the ratio between anxiety and depression had significant difference; for the further analysis, the anxiety and the depression group were divided to two group respectively according to the anxiety/depression of SCL-90 〉 lot 〈 1. No differences was observed in all factors of SCL-90 except depression between the anxiety/depression 〉 1 or 〈 1 groups in anxiety groups. Both the somatic and anxiety of SCL-90 in the anxiety/depression 〉 1 group were significantly greater than those of the anxiety/ depression 〈 1 group （P 〈 0.05） in depression group. Otherwise,both interpersonal sensitivity and depression of SCL-90 in the anxiety/depression 〉 1 group were significant lower than those of the anxiety/depression 〈 1 group （P〈 0.05） in depression group. Conclusion The patients with depression had more severe symptoms than the patients with anxiety. It was hard to differentiate between anxiety disorder and depression disorder only according to symptoms levels. The ratio between anxiety and depression was more valuable than that of absolutely severe of rating results.