老年期抑郁症患者的症状特点分析

Analysis of Symptomatic Features of Senile Depression

目的 了解老年期抑郁症患者的临床症状特点。方法 将 5 8例首次发病的单相抑郁症患者分为 2组 ,其中 2 9例 >6 0岁者为老年组 ,2 9例≤ 6 0岁者为对照组。在入院时和住院 1个月时评定汉密尔顿抑郁量表 ,并比较治疗前后组内因分子的变化。同时对发病诱因、伴发躯体疾病及抑郁症状条目进行比较。结果 老年组与对照组的自杀意念 (分别为 2 1例 ,11例 )、迟缓 (13例 ,2 1例 )、疑病 (18例 ,9例 )、偏执症状 (9例 ,2例 )、焦虑 躯体化 [(8 2± 2 2 )分 ,(4 7± 1 8)分 ]、认知障碍 [(5 7±2 6 )分 ,(3 7± 1 6 )分 ]的差异有显著性 (P <0 0 5 ) ;伴发躯体疾病 (2 2例 ,8例 )、记忆力减退 (19例 ,8例 )的差异有非常显著性 (P <0 0 1) ,发病诱因 (10例 ,14例 )的差异无显著性 (P >0 0 5 )。用氟西汀或帕罗西汀 2 0mg d治疗 1个月后 ,2组组内抑郁症状的比较 ,老年组各症状的差异无显著性(P >0 0 5 ) ;对照组焦虑 /躯体化 [(4 7± 1 8)分 ,(1 9± 1 3)分 ]、日夜变化 [(1 6± 0 7)分 ,(0 3± 0 4)分 ]症状的差异有显著性 (P <0 0 5 ) ,体重变化 [(0 8± 0 8)分 ,(0 2± 0 4)分 ]的差异有非常显著性(P <0 0 1)。结论 老年期抑郁症临床症状特征明显 ,可能为一种异质疾病。

Objective To inquire into the clinical symptomatic features of senile depression Methods 58 cases who meet the Chinese Classification and Diagnostic Criteria of Mental Disorders, 2nd revised edition for early onset unipolar depression were collected in the study 29 of the 58 cases (older than 60 years) were designed as research group, the other 29 (younger than 60 years), were in the control group At admission and after one month of hospitalization, the Hamilton Rating Scales for Depression (HAMD) was assessed in all patients and then total and factors of the HAMD were analyzed and compared The predisposing factors, concomitant somatic diseases and symptoms of depression were also analyzed Results There were significant differences in suicidal ideas (21 cases in observed group to11 cases in control group), relaxation (13 cases to 21cases), hypochondria (18 cases to 9 cases), paranoid symptoms (9cases to 2cases), points of anxiety/somatization (8 2±2 2 to 4 7±1 8) and cognition disorders (5 7±2 6 to 3 7±1 6), ( P <0 05), and extremely significant differences in concomitant somatic diseases (22 cases to 8 cases) and poor memory (19 cases to 8 cases) ( P <0 01), but no significant difference in the predisposing factors (10 cases to 14 cases) ( P >0 05) When the cases were treated with Prozac or Paroxetine 20 mg/day for one month, the symptomatic syndromes did not changed significantly after treatment ( P >0 05)in the research group, but there were significant difference ( P <0 05)in the points of anxiety/somatization (4 73±1 8 before treatment to 1 89±1 3 after treatment) and day night changing syndromes (1 6±0 7 to 0 3±0 4),and extremly significant difference in the points of weight change (0 8±0 8 to 0 2±0 4) in the control group Conclusion The senile depression has its own clinical symptomatic features and it should be a heterogeneous disease