原发性干燥综合征患者抑郁症患病率调查及相关因素分析

The investigation and related factors analysis for the depression of patients with primary Sjogren＇s syndrome

目的了解原发性干燥综合征（pSS）患者抑郁症的患病率，并对相关因素进行探讨，为对其进行早期心理干预提供参考。方法对217例pSS患者先用抑郁自评量表（SDS）进行初步筛查，后采用汉密尔顿抑郁量表（HAMD，17项指标）对患者的抑郁程度进行评分，经精神科医生按中国精神疾病分类与诊断标准第3版（CCMDⅢ）抑郁症诊断标准进行诊断，得到本组患者抑郁症的患病率；再用艾森克人格问卷（EPQ）、生活事件量表（LES）及自制一般情况调查表进行测查。采用t检验，X^2检验及Logistic回归等统计方法对各因素进行分析。结果pSS患者抑郁症的患病率为39．2％（85／217）。患病的相关因素按标准回归系数依次为重度疼痛、医护人员关心、患者知情、负性生活事件、艾森克人格检查量表N因子5项，其中医护人员关心与抑郁患病呈负相关。结论PSS患者合并抑郁症需引起临床医生重视，重度疼痛、缺乏医护人员关心、患者知情、负性生活事件及神经质人格特征的患者更容易合并抑郁症，正确认识这些危险因素对其进行早期心理干预具有指导意义。

Objective To survey the prevalence and the related factors of depression in patients with primary Sjogren＇s syndrome （pSS）, and provide references for early mental intervention. Methods The depression state of 217 patients with pSS was screened with self-rating depression scale （SDS） first and then assessed by Hamilton depression scale （HAMD, 17 index）. The prevalence of depression was determined based on the diagnosis of psychiatrist based on the 3rd edition of Chinese classification of mental disorders （CCMD Ⅲ ）. The personality was evaluated by Eysenck personality questionnaire （EPQ）, and the life events were questionnaired by life events scale （LES）. The general condition was analyzed by self-designed questionnaire. Finally, step-wise multiple factor regression analysis was carried out to determine the risk factors that best accounted for the depression. Results The prevalence rate of depression in patients with pSS was 39.2% （85/217）. There were 5 factors entered the regression equation by multifactor regression analysis. They were severe pain, concerns of doctor and nurse, known of the fact by patients, adverse life events, and neuroticism of EPQ, and the concern of doctor and nurse was negatively correlated. Conclusion More attention from chnicians should be paid to the depression of pSS. Patients with severe pain, lack of attention from doctors and nurses, known of the disease itself, adverse life events and neurotic personality traits are factors related with depression. Recognizing the risk factors early can provide guidance for early psychological intervention.