首次发作抑郁症复发率及其相关危险因素的探讨

A study on recurrence rate of single episode depression and related risk factors

目的探讨首次发作抑郁症复发情况及其相关危险因素。方法按CCMD-Ⅱ-R诊断标准收集了233例经治疗而明显缓解的首次发作抑郁症病人，并进行了1年跟踪随访，采用多因素Logislic回归分析与复发有关的因素。结果（1）首次发作抑郁症1年复发率32．6％；（2）单因素分析显示，服药依从性、急性期治疗时间、家庭情感表达、社会支持评定量表总分、家庭亲密度、疗效指数（E1）、合并精神病性症状、HAMD抑郁量表总分、生活事件量表总分、EPQ的N分、P分11个变量与复发有关；（3）经多因素回归分析有服药依从性、EPQN分、社会支持评定量表总分、合并精神病性症状、HAMD总分、急性期治疗时间入选回归模型。结论首次发作抑郁症复发受多种因素的影响应及早干预。

Objective To explore recurrence of single episode depression and the related risk factors. Methods 233 patients who were diagnosed single episode depression upon the diagnostic criteria single episode depression of the 2nd edition of the Chinese Classification and Diagnositic criteria of Mental （CCMD--2--R） and have shown a marked remittence in depression after treatment, have been followed up for a year. The data were analyzed with logistic model. Results （l） The recurrence rate of single episode depression was 32.6% in the first year. （2） single--factor analysis indicated that drug compliance, the time of treatment in acute period, familiarity and expressiveness in FES--CV. the total scores of LES, the total scores of SOS, efficacy index, psychotic symptoms, the total scores of HAMD, N and P factors in EPQ were associated with the recurrence rate of single episode depression. （3） By multiple data analysis, drug compliance, N and P factors in EPQ, the total scores of SOS, psychotic symptoms, the total scores of HAMD, the time of treatment in acute period were selected for the regression analysis. Conclusions the recurrence of single episode depression is influenced by many factors, should be inter- vened in early.