颅脑损伤后抑郁障碍的相关因素

A study of the prevalence of depressive disorder and correlated factors after traumatic brain injury

目的评估颅脑损伤后抑郁障碍的发生状况。方法选择颅脑损伤患者64例,采用汉密尔顿抑郁量表17项和美国精神障碍诊断与统计手册第4版进行评估和诊断。结果有25例（39.06%）颅脑损伤患者符合中重性抑郁症的诊断标准,logistic回归分析（进入法）提示,年轻（OR=21.3,95%CI 19.7-32,P〈0.001）、女性（OR=0.79,95%CI 0.7-1.2,P=0.042）和开放式颅脑损伤（OR=3.9,95%CI 2.8-7.9,P=0.03）更有可能患抑郁障碍,这些变量可以解释抑郁障碍发生的39.2%（R^2=0.392,P〈0.001）。结论颅脑损伤后抑郁障碍的发生率高,年轻、女性、开放性颅脑损伤是抑郁障碍发生的易感因素,需关注颅脑损伤后抑郁障碍的识别和治疗。

Objective This study examined the occurrence of depressive disorder related to traumatic brain injury（ TBI）. Methods All 64 participants were diagnosed with TBI and classified into different types of TBI. HAMD- 17 was used to assess depressive symptoms,and DSM- Ⅳ for diagnosis of depressive disorder. Results There were 25 cases（ 39. 06%） meeting the diagnosis of moderate or major depressive disorder. Multiple logistic regression analyses revealed that young age（ OR = 21. 3,95% CI 19. 7 - 32. 0,P〈 0. 001）,female（ OR = 0. 79,95% CI 0. 7 - 1. 2,P = 0. 042） and open TBI（ OR = 3. 9,95% CI 2. 8 - 7. 9,P = 0. 03） were the susceptible factors of the occurrence of depressive disorder（ R^2= 0. 392,P〈 0. 001）. Conclusion The prevalence of depressive disorder related to TBI is high. Young age,female and open TBI are the risk factors. The identification and treatment for depressive disorder required attention in TBI patients.