成都市儿童青少年抑郁障碍临床特征调查

Clinical characteristics of depression among 6～16 years old children and adolescents in Chengdu

目的探讨成都市儿童青少年抑郁障碍的临床特征。方法采用量表筛查和访谈结合的方法对成都市五城区6～16岁的4585名在校学生进行抑郁障碍调查。首先应用长处和困难问卷(strength and difficulty questionnaire,SDQ)进行筛查,筛查阳性的进一步用精神发育和健康状况评定量表(the development andwell-being assessment,DAWBA)进行定式检查以明确诊断。诊断标准按照美国精神障碍诊断和统计手册第4版。结果 SDQ筛查阳性的占50.2%(2302/4585)。共检出儿童青少年抑郁障碍患者55例,重性抑郁障碍29例,恶劣心境0例,未标明的抑郁障碍26例,总的抑郁障碍患病率1.2%(55/4585)。起病年龄的中位数为13岁(P25:11岁,P75:15岁),高峰年龄在15岁,占21.8%(12/55)。出现频率居前3位的抑郁症状依次是情绪低落(74.5%)、易激惹(72.7%)、精力减退(72.7%)。34.5%(19/55)的儿童青少年抑郁障碍患者曾经试图伤害自己或自杀。55例患者中39例过去曾有抑郁发作,占70.9%。抑郁障碍对儿童青少年的学习、社交和娱乐具有不同程度的影响,74.5%(41/55)的患者学习受影响。患者的病情有轻有重,大多数(78.2%)为轻度或中度。结论儿童青少年抑郁障碍应受到重视,做到早发现早治疗。

Objective To determine the clinical characteristics of depression among 6 - 16 years old children and adolescents. Methods A cross-sectional studies was conducted in 4585 children and adolescents in grades 1 - 10 in Chengdu. All subjects were first screened for depression using strength and difficulty questionnaire （SDQ） and those with SDQ-identified depression were then assessed using the development and well-being assessment （DAWBA）. Their final diagnosis were made according to diagnostic and statistical manual of mental disorders-fourth edition （DSM-IV）. Results SDQ detected total 55 patients from 4585 children and adolescents and the positive rate was 50.2% （2302/ 4585）. Among them, 29 patients had major depression, 26 patients had depression NOS. The overall prevalence of depressive disorders was 1.2% （55/4585）. The median age of onset was 13 years old （P25：11 years old, P75：15 years old） and the peak age of onset was 15 years old, which accounted for 21.8% （12/55） of total patients. The three most common symptoms of depression, in a descent order, were depressed mood （74.5%）, irritability （72.7%） and fatigue or decreased energy （72.7%）. 34.5% （19/55） of children and adolescents with depressive disorders had experiences to try to hurt themselves or commit suicide and 70.9% （39/55） patients had a past history of depression. Depression impaired learning, social and entertainment of depressed children and adolescents to varying degrees. 74.5% （41/55） of Patients had learning problems. The condition was usually mild to moderate in the majority （78.2%, 43/55） of patients. Conclusion Depressive disorder during children and adolescents should be paid attention to early detectedamd early treated.