急性期治疗后达到临床缓解的抑郁症患者残留症状对社会功能的影响

Effects of residual symptoms on social functional in patients with depression after clinical acute phase remission

目的评价经过8～12周急性期治疗达到临床缓解的抑郁症患者残留症状对社会功能恢复的影响。方法本研究为多中心、两期研究，第一周期为横断面调查，研究时间为2014年9月-2015年4月，第二周期为队列研究，时间为2015年9月～2017年8月。本研究选择两周期受试者的基线，即本次抑郁发作治疗8～12周急性期末的受试者评估数据。对患者进行16项抑郁症状快速评估量表（QIDS—SR16）、患者健康问卷-躯体症状群量表（PHQ-15）和席汉残疾量表（SDS）评估。以QIDS—SR16中9个维度≥1分作为单个残留症状标准。SDS总分〉6分和分条目分〉2分为功能受损标准。结果纳入925名受试者，根据功能是否有所损伤分为两组，其中在急性期治疗后仍存在功能损伤受试者为24．22％（224／925）。存在躯体症状、本次发作为复发、仍存在睡眠问题、兴趣缺失、疲倦及焦虑等因素影响受试者的功能缓解。结论急性期治疗后达到临床缓解的患者存在残留症状是其功能受损的影响因素。

Objective To evaluate the effects of residual symptoms on the recovery of social function in patients with depression after clinical treatment of acute remission after 8 to 12 weeks. Methods This study was a muhicenter, two-phase study. The first cycle was cross-sectional survey （from September 2014 to April 2015） and the second cycle was cohort study （from September 2015 to August 2017）. The assessment data of the subjects at the end of acute period in this 8 to 12 week treatment of depressive episode was chosen as the baseline for all the subjects. Patients were assessed for Brief 16-Item Quick Inventory of Depressive Symptomatology Self- Report （QIDS-SR16）, Patient Health Questionnaire-15 （PHQ-15） and Sheehan Disability Scale （SDS）. Any 9 dimensions of QIDS-SR16 in excess of 1 was taken as a single residual symptom standard, and the total score of SDS over 6, item score over 2 was taken as functional impairment standard. Results A total of 925 subjects were enrolled and divided into two groups based on their functional impairment. There were still about 24.22% （224/925） of those with functional injury. Physical symptoms, recurrence patients, sleep problems, lacking of interest, fatigue and anxiety and other factors affect the subject＇s functional remission. Conclusions Residual symptoms in patients who achieve clinical remission after acute phase are the influencing factors of their functional impairment.