浏阳市农村社区重症抑郁发作患者的症状特点

Symptom Characteristics of Major Depressive Episode in Rural Communities of Liuyang

目的:探讨农村社区重症抑郁发作患者的症状特点。方法:以2007年3～5月浏阳市农村抑郁症抽样调查中筛查发现并确诊的重症抑郁发作患者234例为研究对象,由培训合格的调查员按照SCID的要求调查重症抑郁发作各症状发生情况。结果:在重症抑郁发作的9条症状阳性率依次为抑郁或情绪低落(96.6%)、兴趣或愉快感缺失(85.0%)、疲倦或精力缺失(84.6%)、睡眠变化(83.3%)、饮食或体重的变化(68.4%)、思考或集中注意力障碍(64.5%)、无价值感或不适当的自罪感(62.4%)、自杀意念或行为(37.2%)和精神运动激越或迟滞(27.4%),有7.7%的患者9项症状全部阳性。男性饮食和体重变化阳性率(76.7%)显著高于女性(63.5%);女性患者自杀意念和自杀未遂的阳性率(40.2%)显著高于男性(30.2%)。躯体症状中最常见的是疲倦或精力缺失,其次是睡眠变化和食欲与体重改变,患者报告的平均睡眠时间只有4.53小时。结论:农村社区人群一些症状的阳性率低于临床患者,应进一步加强社区抑郁症患者的症状特点研究,提高抑郁症的主动就医率和临床识别与诊断率。

Objective： To explore the symptom characteristics of major depressive episode in rural communities. Methods ： 234 patients with MDE were screened out and confirmed in the sampling survey of depression in rural residents of Liuyang from March to May 2007. All the patients were interviewed by well-trained investigators to examine the 9 symptoms of MDE according to SCID. Results： The sequence of positive rates of the 9 symptoms of MDE from highest to lowest were depressed mood（96.6%）, diminished interest or pleasure in a11（85.0%）, fatigue or loss of energy（84.6%）, insomnia or hypersomnia（83.3%）, appetite or weight change（68.4%）, diminished ability to think or concentrate, or indecisiveness （64.5%）, feelings of worthlessness or excessive or inappropriate guilt （62.4%）, recurrent suicidal ideation or attempt （37.2%） and psychomotor agitation or retardation（27.4%）; and 7.7% of the patients were all positve of the 9 symptoms. The positive rate of appetite or weight change in males （76.7%） was significantly higher than in females （63.5%）, while the positive rate of suicidal ideation or attempt in females （40.2%） was significantly higher than males （30.2%）. Among the somatic symptoms, the most frequent was fatigue or loss of energy, followed by insomnia or hypersomnia and appetite or weight change. The mean sleeping time reported by patients was only 4.53 hours a day. Conclusion： Compared with clinical patients with MDE, the positive rates of some symptoms （such as appetite and weight change） are lower in rural community patients than in hospitalized patients. The results indicate to make further studies on symptom characteristics of community patients with dpression in order to promote the depression patients to seek professional helps actively and to elevate the recognise or diagnosis of depression.