城市部分移民抑郁障碍的临床特征

Clinical characteristics of depressive disorder in urban migrants

目的探讨移民因素对抑郁障碍患者临床特征的影响。方法根据患者是否移民将134例抑郁障碍患者分为移民组(66例)与对照组(68例)。采用《美国精神障碍分类与诊断标准(第4版)》(DSM-Ⅳ)对患者进行诊断及评估,采用蒙哥马利抑郁评定量表(MARDS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估抑郁患者病情严重程度。结果 (1)移民组与对照组的MADRS评分差异有统计学意义[(27.04±1.02)vs.(23.63±2.52),t=10.333,P<0.05]、HAMD评分差异有统计学意义[(30.87±5.60)vs.(25.63±4.52),t=5.948,P<0.05]、HAMA评分差异有统计学意义[(23.13±5.49)vs.(15.75±4.52),t=8.483,P<0.05]、治疗缓解率差异有统计学意义(17.35%vs.45.23%,χ2=13.019,P<0.05)。(2)抑郁障碍与广场恐惧症、惊恐障碍、创伤后应激障碍、躯体化障碍、持续疼痛障碍等共病,移民组发生率显著高于对照组(P<0.05)。(3)移民组在睡眠障碍、认知症状、无价值感、激越/迟滞、自杀意念、幻觉/妄想等症状的发生率显著高于对照组(P<0.05)。结论城市移民抑郁障碍患者抑郁程度较重,共病焦虑障碍发生率高,且缓解率较低,应引起政府的高度重视。

Objective To study the influence of clinical features in migrants with depressive disorder.Methods A total of 134 patients with depressive disorder were divided into the immigrant group（66 cases）and control group（68 cases）.Using the UNITED STATES CLASSIFICATION AND DIAGNOSTIC CRITERIA FOR MENTAL DISORDERS FOURTH EDITION（DSM-Ⅳ）to diagnose and assess the patients,the amount of Montgomery depression rating scale（MARDS）and Hamilton depression scale（HAMD）,Hamilton anxiety scale（HAMA）assess the degree of depression were used to assess patients with severe disease.Results There were statistical differences in MADRS scores[（27.04 ±1.02）vs.（23.63±2.52）,t=10.333,P〈0.05],HAMD scores[（30.87±5.60）vs.（25.63±4.52）,t=5.948,P〈0.05],HAMA scores[（23.13±5.49）vs.（15.75±4.52）,t=8.483,P〈0.05）,]and treatment remission rate（17.35%vs.45.23%,χ2=13.019,P〈0.05）between the two groups.The incidence of depression and agoraphobia,panic disorder,post-traumatic stress disorder,somatic disorder,and persistent pain disorder were significantly higher than those in the control group（P〈0.05）.The rates sleep of disorders,cognitive symptoms,sense of no value,agitation/hysteresis,suicide,and illusion/delusion in group of immigrants were significantly higher than that of control group（P〈0.05）.Conclusion The condition of urban immigrants with depressive disorder is serious,its incidence of comorbid anxiety disorders is high and the rate of remission is low,which should be paid more attention by the government.