儿童期情感性精神障碍临床特点的对照研究

Clinical comparison study of childhood affective disorders

目的 探讨儿童情感性精神障碍的临床特征。方法 将 5 4例符合中国精神疾病分类方案与诊断标准第 2版修订本中情感性精神障碍、年龄≤ 16岁的患者 (儿童少年组 ,以下简称儿少组 ) ,与随机抽取的同期住院的 5 3例成年情感性精神障碍患者 (成人组 )的临床特征进行对照分析。结果 儿少组缓慢起病者 (5 0 % )多于成人组 (2 3% ) ,发病次数 [(3 3± 4 2 )次 ]多于成人组 [(2 3±1 8)次 ;χ2 =6 11～ 9 0 5 ,P <0 0 5 ];儿少组情感性精神障碍的核心症状与成人组无本质区别 ,其中在联想困难、疑病、自杀观念、自杀行为、疲乏、体重下降、食欲下降方面少于成人组 (P <0 0 1,P <0 0 5 ) ,焦虑、激越和学习成绩下降多于成人组 (P <0 0 1) ;躁狂症精力充沛、精神运动性兴奋、社会功能受损少于成人组 (P <0 0 5 ,P <0 0 1) ;儿少组的抑郁发作者有 2 6 %、躁狂发作有 6 6 %分别伴有行为问题 ;儿少组的幻听、牵连观念及怪异行为多于成人组 (P <0 0 5 )。结论 儿童抑郁症和躁狂症伴有较多的行为问题 ;

Objective To explore the clinical characteristics of children and adolescents affective disorders and the difference compared with adults Methods The clinical characteristics in 54 children and adolescents under the age of 16, who met the CCMD 2 R criteria for affective disorder were analyzed and compared with adult patients with the same disorder who admitted into hospital during the same time Results There was no essential difference between the core symptoms of children and adults affective disorder Children′s depression and mania symptoms showed a different clinical phase compared with adults With depression, there was more anxiety and agitation while less fatigue, hypochondriac, suicide attempt, weight loss, appetite loss than adults With mania, there was less vigor, psychomotor excitement than adults Among the children with depression, 25 64% showed behavior problems, while 65 79% of the children with mania showed behavior problems, such as resistance, disobedience, attack behavior and run away from home Children and adolescents patients showed more psychotic symptoms such as hallucination, reference ideas, weird behaviors and less delusion compared with adults Children and adolescents patients had fewer onset causes and more chronic disease period Conclusions Childhood and adult affective disorders may be the same disorder only with the different onset age