非精神科门诊抑郁症的躯体化研究

Investigation on Somatization of Depression in Non-psychiatric Department

目的探讨非精神科门诊抑郁症的临床特点、治疗及误诊情况。方法对符合DSM-IV抑郁症诊断标准,且汉密尔顿抑郁量表（HAM D）评分≥18,抑郁自评量表（SDS）评分≥60（标准分）的72例以躯体不适就诊于非精神科门诊,经多方查治无效而转入精神科门诊的患者,进行临床及量表分析。结果 72例中,有77.8%的初诊患者第一主诉是躯体不适和睡眠障碍,而非抑郁症状。经氟西汀治疗6周后,HAM D、SDS及汉密尔顿焦虑量表（HAMA）评分明显下降（P〈0.01）。结论非精神科门诊抑郁症患者正确识别可减少误诊发生,抗抑郁剂的应用可有效缓解抑郁症状和躯体不适。

Objective To study the clinical features,treatment and misdiagnosis of depression in non-psychiatric department.Methods All patients referred to psychiatric outpatient department were screened with depression according to DSM-IV,and HAMD and SDS,72 of them scored higher than 18 of HAMD and 60 of SDS.Then their clinical features,treatment and scales were analysed.Results Among 72 patients with depression,77.8% consulted their physician with chief complaint of somatic discomfort or sleep disorder first.The scores of HAMD,SDS and HAMA significantly decreased after 6 weeks treatment with Flucidine（P0.01）.Conclusion Correct recognition of depression in non-psychiatric department may reduce the misdiagnostic rate.Antidepressant can improve de-pression and somatic discomfort.