长期住院精神分裂症患者伴发抑郁症状的影响因素分析

Concurrent depressive symptoms and their clinical correlates of long-term inpatients with schizophrenia

目的：探讨长期住院精神分裂症患者伴发抑郁症状及影响因素。方法：采用卡尔加里精神分裂症抑郁量表（CDSS-C）对长期住院（≥12个月）的200例精神分裂症患者进行抑郁症状的评估,以CDSS-C总分是否≥6分,将患者划分为伴抑郁组58例和非抑郁组142例,运用Logistic回归模型分析伴发抑郁症状的影响因素。结果：抑郁组在女性构成比、探视频率〈1次/月、抗精神病药单药治疗率、合并苯海索或苯二氮艹卓类药、有自杀意念构成比、阳性症状量表（SAPS）总分、阴性症状量表（SANS）总分和一般精神病理总分明显高于非抑郁组（P〈0.05或P〈0.001）;主要探视人为I级亲属的构成比及平均住院周期显著低于非抑郁组（P〈0.05或P〈0.001）。Logistic回归分析显示主要探视人为I级亲属（OR=0.207,95%CI：0.072-0.591）、探视频率〈1次/月（OR=3.869,95%CI：1.332-11.239）、有自杀意念（OR=9.256,95%CI：3.191-26.854）是抑郁症状的影响因素（P〈0.01或P〈0.001）。结论：探视人（I级亲属）、探视频率及有自杀意念是长期住院精神分裂症患者伴发抑郁症状的主要影响因素。

Objective：This report aimed at exploring magnitude of concurrent depressive symptoms and their clinical correlates of long-term inpatients with schizophrenia. Method：A cross-sectional survey was conducted on a total of 200 long-term（≥ 12 months）inpatients that met the international classification of dis-eases,10th version criteria for schizophrenia. Calgary depression scale for schizophrenia,CDSS-C（Chinese ver-sion）were used to assess depressive symptoms of the participants. A Logistic regression model was developed to estimate correlates of concurrent depressive symptoms. Results：Up to 29%（n = 29）of participants adopted significant depressive symptoms based on a total score of CDSS-C≥6. Participants with depressive symptoms were more likely to be female,had less family visitations（less than one visitation per month）,had antipsychotic monotherapy,or combination therapy with either benzhexol or benzodiapine,and endorsed suicidal ideation（all P 〈 0. 05）. Participants with depressive symptoms had less first degree relative visitors than those without de-pressive symptoms（P 〈 0. 05 or P 〈 0. 001）. Participants with depressive symptoms had significantly higher total score of scale for assessment of positive symptoms as well as scale for assessment of negative symptoms and general psychopathological scale（P 〈 0. 05 or P 〈 0. 001）. Results of Logistic model analysis indicated first de-gree relative visitors（OR = 0. 207,95% CI：0. 072-0. 591）,family visitations less than once time per month （OR = 3. 869,95% CI：1. 332-11. 239）and co-occurring suicidal ideation（OR = 9. 256,95% CI：3. 191-26. 854） were associated with concurrent depressive symptoms of participants（P 〈 0. 05 or P 〈 0. 001）. Conclusion：Concurrent depressive symptoms is common among long-term inpatients with schizophrenia and first degree rela-tive visitors and family visitation frequency may probably have an impact on those.