新兵适应障碍与抑郁发作临床特征对照研究

Comparative Study on Clinical Features Between Adjustment Disorders and Depressive Episode in Recruits

目的比较新兵适应障碍与抑郁发作临床特征之间的异同,为两者的临床鉴别诊断及适时干预提供参考。方法以作者医院2016~2017年度鉴定诊断为适应障碍和抑郁发作的新兵为研究对象,对一般资料及临床特征进行回顾性对照分析。结果共纳入研究对象69例,其中适应障碍44例,抑郁发作25例。两组在年龄、病程、既往史等方面差异有明显统计学意义(P<0.01),且抑郁发作可能更常见于独生子女、单亲家庭和有留守儿童经历的新兵,更多有创伤经历、受虐史和精神障碍家族史;适应障碍新兵更多在入伍前对部队缺乏了解,且入伍前工作经历较少。适应障碍与抑郁发作焦虑、抑郁、躯体症状等临床症状群表现相似,自杀行为风险较高。适应障碍更易发生自伤行为,但自杀未遂的比例相对较低。结论新兵的适应障碍与抑郁发作两者临床特征多有相似,其鲜明的区别在于,新兵适应障碍发病年龄较轻、症状出现较早,抑郁发作则多有既往史。

Objective To compare the similarities and differences in the clinical features between adjustment disor- ders （AD） and depressive episode （DE）, and provide references for the clinical differential diagnosis and timely interven tion. Methods Recruits with diagnosis of AID and DE in the author＇s hospital between 2016 and 2017 were collected into this study, meanwhile the genral data and clinical features were analyzed and compared retrospectively. Results Sixty- nine subjects were enrolled, including 44 cases of AID and 25 cases of DE. There were significantly differences in age, course of disease, past medical history between two groups （P〈0. 01）. DE was more likely common in only children, single parent families and recruits with left-behind children, more traumatic experiences, abuse histories or family history of mental disorder. Recruits with AD were short of understanding through their inexperience before enrollment. The anx- iety, depression, somatization and other clinical symptoms between AD and DE had similar performances and higher sui- cide risk. And AD was more likely to cause self-injurious behavior, but the proportion of attempted suicide was relatively low. Conclusion The clinical characteristics between AD and DE in miIitary recruits are highly similar. The most differ- ence lies in the younger age of recruits to appear AD, the earlier onset of symptoms, while more DE episodes than the past.