综合性医院不典型抑郁障碍74例分析

Analysis of 74 Patients with Atypical Depressive Disorder in General Hospital

目的 :探讨综合性医院神经科门诊不典型抑郁障碍的特点 ,避免误诊及漏诊。方法 :对符合 CCMD- 2 - R抑郁诊断标准 ,Zung评分≥ 40 ,HAMD(17项 )评分≥ 17分的 77例患者进行临床及量表分析。结果 :以躯体症状为第一主述者占 98.6 5 % ,其中头痛、头晕者占 43.2 4%。2 / 3以上的患者存在多种抑郁常见症状 ,其中兴趣减退及情绪低落存在于所有患者 ,前者较后者更重。无自杀行为的病例。 Zung平均总组分 5 0 .5 5分 ,HAMD平均分 19.5 5分。 HAD- A评分≥ 9分者明显多于 <9分者 ,前者的 Zung评分明显高于后者。结论 :综合性医院神经科门诊不典型抑郁患者多以躯休症状为第一主述就诊 ,多数患者存在多种抑郁常见症状 ,患者多为轻度抑郁。多伴有焦虑 ,伴焦虑者的抑郁程度较重。

Objective:the purpose of this study was to determine the feature of atypical depression in general hospital neurologic clinic.Methods:74 patients who met CCMD 2 R criteria for depression,Zung self Rating Depression Scale scores≥40 and 17 item Hamilton Depression Rating Scale scores≥17 were enrolled in this study.Results:The rate of the first complain was 98.65% for somatic symptoms,43.24% for headache and dizziness.More than two thirds of patients showed depressed symptoms,loss of interest and depressed mood existed in all cases,the degree of loss of interest was more serious than that of depressed mood.No suicidal attempts showed.Zung's scale mean scores was 50.55,Hamilton's scale mean scores was 19.55.Patients with HAD A scale scores≥9 were more than those with HAD A scale scores<9.The former's Zung's scale mean scores was higher than the latter.Conclusion:Somatic symptoms especially headache and dizziness as the first complain were much more common in atypical depression.Most of patients showed depressed symptoms,the degree of depression was mild in most of subjects.Most cases accompanied anxiety,the degree of depression was more serious in patients accompaning anxiety.