中青年与老年抑郁症患者临床特征及药物治疗的对比研究

A comparative study of the clinical features and medical treatments between young and middle-aged and elderly patients with depression

目的对267例成年抑郁症患者的临床特征及治疗药物特点进行回顾性分析,探寻中青年与老年抑郁症患者在临床特征及治疗方面有无差异。方法采取回顾性分析方法,调阅2010~2011年南方医科大学附属南方医院中医科门诊及病房299例抑郁症患者病历,选择其中病历资料完整并符合本研究要求的267例进行分析,中青年组234例,老年组33例。结果 2组患者在年龄、文化程度及婚姻构成比差异有统计学意义,在性别及家族史阳性差异无统计学意义;在生活事件方面,中青年组与老年组相比差异无统计学意义（P〉0.05）。老年组合并躯体疾病发生率高于中青年组（P〈0.05）。老年组在情绪改变、自杀意念及躯体化症状发生率高于中青年组（P〈0.05,P〈0.01,P〈0.05）,尤其在自杀意念及躯体化症状表现上更为明显。2组患者在药物治疗方面,包括抗抑郁药合用中药的治疗方式,差异无统计学意义。结论成年抑郁症患者在起病诱因上有差异,随着年龄的增长,以躯体疾病为诱因引发抑郁症的比例会增大。成年抑郁症患者在临床症状也存在差异,相对中青年患者,老年患者有更多的情绪改变、自杀意念及躯体化症状。成年患者在抗抑郁药物选择上差异无统计学意义。

Objective To explore whether there are differences in terms of clinical features and medical treatments between the young-and middle-aged and elderly patients with depression by a retrospective analysis of 267 adult patients with depression.Methods A retrospective analysis was conducted to review the clinical data of 299 patients who received treatments in our hospital between 2010 and 2011.A total of 267 patients who met the requirements of the study were finally selected and divided into young and middle-aged group（n=234） and the elderly group（n=33）.Results The two groups showed statistically significant differences in age,educational background and marital status,but no significant statistical differences were found in gender and family history.In terms of life events,there was no statistically significant difference between the two groups（P0.05）.The incidence rate of somatization disorders was higher in the elderly group than in the young and middle-aged group（P0.05）.The incidence rates of emotional change,suicidal intention and somatization symptoms,particularly suicidal intentions and somatization symptoms,were higher in the elderly group than in the young and middle-aged group（P0.05,P0.01,P0.05）.Two groups showed no statistically significant differences in medical treatments,including the combination of antidepressants and traditional Chinese medicines.Conclusion There are many causes leading to the depression in adults,moreover the percentage of depression resulting from somatic disease could increase along with increase of age.And also a difference in clinical manifestations exists in adult depression patients.Compared with the young and middle-aged patients,the elderly patients have more emotional changes,suicidal intentions and somatization symptoms.However,dult patients may have no statistically significant differences in choosing antidepressant drugs.