单相与双相抑郁障碍患者临床特征的对照研究

Comparative study on clinical features of patients with unipolar and bipolar depression

目的比较单相与双相抑郁障碍患者的临床特征,为单相和双相抑郁障碍的鉴别诊断提供参考。方法连续入组2012年6月-2013年11月在广州医科大学附属脑科医院住院、符合《国际疾病分类(第10版)》(ICD-10)诊断标准的单相抑郁障碍(单相组,n=72)和双相抑郁障碍(双相组,n=64)患者,收集并分析两组一般人口学资料和临床特征,采用汉密尔顿抑郁量表17项版(HAMD-17)评定抑郁症状。结果单相组女性及已婚患者比例均高于双相组(χ2=18.74、4.68,P<0.05或0.01);双相组平均起病年龄小于单相组(t=-2.13,P=0.035);双相组性格外向者比例高于单相组(χ2=9.74,P=0.002);单相组有病前诱因者比例高于双相组(χ2=18.96,P<0.01);双相组伴不典型抑郁症状者比例高于单相组(χ2=24.60,P<0.01);双相组既往抑郁发作次数多于单相组(Z=-5.37,P<0.01);单相组HAMD-17总评分及躯体化焦虑和食欲减退因子评分均高于双相组,差异均有统计学意义(t=-2.78^-2.06,P<0.05或0.01)。结论单相与双相抑郁障碍患者在性别、婚姻状况、发病年龄、是否有病前诱因、是否伴不典型抑郁症状、既往发作次数及HAMD-17评分方面存在差异。

Objective To explore the different clinical features between unipolar and bipolar depression,so as to provide references for the differential diagnosis. Methods The participants were The Affiliated Brain Hospital of Guangzhou Medical University inpatients from June 2012 to November 2013,and some of them were diagnosed with unipolar depression（ unipolar group,n = 72）while others were diagnosed with bipolar depression（ bipolar group,n = 64） according to International Classification of Diseases,tenth edition（ ICD-10）. The general demographic information and clinical characteristics of all participants were collected and analyzed.Hamilton Depression Scale-17 item（ HAMD-17） was applied to assess the depression symptoms. Results The proportion of female and married patients in unipolar group were higher than those in bipolar group（ χ2= 18. 74,4. 68,P 〈 0. 05 or 0. 01）. Average onset age of patients in bipolar group was lower than that in unipolar group（ t =-2. 13,P = 0. 035）. The proportion of extroverts in bipolar group was higher than that in unipolar group（ χ2= 9. 74,P = 0. 002）,and it showed that more patients developed depression with inducement in unipolar group compared with bipolar group（ χ2= 18. 96,P 〈 0. 01）. The proportion of patients with atypical depression symptoms in bipolar group was higher than that in unipolar group（ χ2= 24. 60,P 〈 0. 01）. The times of depressive episodes in bipolar group were more than that in unipolar group（ Z =-5. 37,P 〈 0. 01）. The total score of HAMD-17,score of somatization anxiety and anorexia factor of unipolar group were higher than those of the bipolar group,the difference was statistically significant（ t =-2. 78 ^-2. 06,P 〈 0. 05 or 0. 01）. Conclusion There are differences between patients with unipolar depression and bipolar depression on gender,marital status,onset age,whether develop depression with inducement,atypical depression symptoms,previous times of depressive episodes and HAMD-17 score.