综合性医院就诊病人伴发的抑郁焦虑症状及其治疗

Clinical characteristics and psychotropic therapy of depressive and anxious symptoms of patients with somatic diseases

目的探索各科躯体疾病患者伴发焦虑抑郁症状的临床特征及评价选择性５羟色胺再摄取抑制剂（ＳＳＲＩ）的治疗作用。方法收集综合性医院住院或门诊病人，医院焦虑抑郁评定量表（ＨＡＤ）＞７分者，汉密顿抑郁量表（ＨＡＭＤ）评分＞１２分，汉密顿焦虑量表（ＨＡＭＡ）＞１０分，临床疗效总体量表（ＣＧＩ）≥３分。服用赛乐特，每日１０～２０ｍｇ，共观察６周。疗效评定分为显著进步、进步、稍进步、无效４级。结果（１）入组者共计２００例，１９５例完成治疗，５例中止；（２）抑郁症状严重程度顺位：肿瘤疾病、血液病、内分泌疾病、抑郁症、心血管疾病、肾脏疾病；（３）赛乐特对抑郁症状的改善：显著进步及进步达６１６％，稍进步３０３％，无效８２％；对焦虑症状的改善：显著进步６１５％，进步２９７％，无效８７％。结论躯体疾病伴发抑郁焦虑症状在不同疾病间有相对不同的特征：ＳＳＲＩ代表药物赛乐特对躯体疾病伴发的抑郁焦虑症状有较理想的疗效。

Objective To explore the characteristics of depressive and anxious symptoms and the drug therapy response of patients with somatic diseases. Methods All the subjects were inpatients in a general hospital. The depressive and anxious symptoms met with the following conditions: hospital anxiety and depression scale (HAD)>7 scores, Hamilton Depression Scale (HAMD) >12, Hamilton Anxiety Scale (HAMA) >10, Clinical Global Impression (CGI) 3. Results In patients 200, 195 received the therapy, and 5 discontinued. The severity of depressive symptom in descending order was tumor group, blood disease group, endocrine disease group, depressive group, cardiovascular disease group, renal disease group. The effects of Seroxat (serotonin selective reuptake inhibitor, SSRI): showed that the overall efficacy against depressive and anxious symptoms, measured with 50% reduction rate in endpoint scales scores, was 61.6% and 61.5% respectively. Conclusion Different characteristics of emotional symptoms existed among different somatic diseases. Seroxat is effective in treating emotional problems of patients with somatic diseases.