女性复发性抑郁症与广泛性焦虑共病的临床特征研究

Study on clinical features of female patients with recurrent major depression comorbidity with general anxiety disorder

目的 探讨共病广泛性焦虑的女性复发性抑郁症患者的临床特征.方法 收集女性复发性抑郁症患者301例,根据是否共病广泛性焦虑把入组患者分为共病组和非共病组;对两组患者的人口学资料、临床特征、精神病理学、艾森克神经质量表、生活应激事件量表、父母亲情关系量表等进行比较.结果 女性复发性抑郁症患者共病广泛性焦虑发生率为25.2％ （76/301）,两组患者人口学资料差异无统计学意义,与非共病组比较,共病组在总的症状（OR=1.439,95％ CI=1.049～ 1.975,P=0.024）、总病程（OR=1.253,95％ CI=1.010～ 1.475,P=0.048）、精神运动性激越（OR=2.031,95％ CI =1.123～3.676,P=0.019）、自杀意念（OR=2.228,95％ CI=1.010～4.912,P=0.047）、焦虑（OR=5.547,95％CI=1.935～ 15.896,P=0.001）、易激惹（OR=1.956,95％ CI=1.081～3.542,P=0.027）方面差异有统计学意义.共病组在神经质维度上要明显高于非共病组（OR=2.287,95％ CI=1.674～3.124,P=2.287×10-）.共病组较非共病组遭遇更多的生活压力事件,差异无统计学意义（OR=1.118,95％CI=0.913～ 1.368,P=0.280）.结论 女性复发性抑郁症与广泛性焦虑共病是常见的现象,共病使抑郁症症状更为严重,神经质更为突出。

Objective To explore the clinical features of female diagnosed recurrent major depression （MD） comorbidity with general anxiety disorder （GAD）.Methods 301 females patients with recurrent major depression were interviewed by specially trained interviewers with using computer evaluation system and divided into comorbidity group and non-comorbidity group according to whether comorbid MD with GAD or without GAD.The comparison between the two groups included items of demographic,clinical data,assessment of psychopathology,Eysenck neuroticism questionnaire （EPQ）,stressful life events,parental bonding instrument.Results 25.2% of patients of MD coexistence GAD.There was no significant difference in sociodemographic data between the two groups.Significant differences among total number of depression symptoms（OR=1.439,95% CI =1.049-1.975,P =0.024）,duration of illness（OR=1.253,95% CI =1.010-1.475,P=0.048）,psychomotor agitation（OR=2.031,95% CI =1.123-3.676,P=0.019）,suicidal thought（OR=2.228,95% CI =1.010-4.912,P=0.047）,anxiety（OR =5.547,95% CI =1.935-15.896,P=0.001）,irritable（OR=1.956,95% CI =1.081-3.542,P=0.027） were identified between the two group.In the comorbidity group,the score of nenroticism dimention derived from EPQ was also higher（OR=2.287,95% CI =1.674-3.124,P=2.287× 10-7） than that of non-comorbidity group.There was no significant difference of stressful life events between two groups（OR=1.118,95% CI =0.913-1.368,P=0.280）.Conclusion This study suggests the phenomena that female patients of recurrent depression disorder comorbidity with general anxiety disorders is common in clinical.The patients comorbid MD and GAD have more symptoms,neuroticism and be worse in severity.