艾司西酞普兰对抑郁症伴焦虑症患者睡眠质量和自杀风险的影响

Effect of escitalopram on sleep quality and suicide risk in patients with depression complicating anxiety

目的探讨艾司西酞普兰对重症抑郁症伴焦虑症患者睡眠质量和自杀风险的影响。方法选择2014年8月至2017年10月西安市精神卫生中心临床心理1科收治的62例重症抑郁症伴焦虑症患者,采用随机数字表法均分为观察组和对照组。观察组给予艾司西酞普兰治疗,对照组给予米氮平治疗,治疗周期为2个月;于治疗前后,采取汉密尔顿抑郁量表(HAMD)观察患者的抑郁程度,并采用匹兹堡睡眠质量指数量表(PSQI)评价药物对患者睡眠质量的影响,通过计算自杀态度总分(SA)和自杀倾向得分评价药物对患者自杀风险的影响。结果与治疗前相比,两组治疗后HAMD评分显著降低,差异均有统计学意义(P<0.05);与对照组相比,观察组PSQI评分显著低于对照组,且观察组SA较对照组高,自杀倾向得分较低,差异均有统计学意义(P<0.05)。结论艾司西酞普兰可有效改善重症抑郁症伴焦虑症患者的睡眠障碍,提高睡眠质量,降低患者的自杀风险,安全性较高,临床效果较好。

Objective To investigate the effect of escitalopram on the sleep quality and suicidal risk in the patients with major depression complicating anxiety.Methods A total of 62 patients with major depression complicating anxiety in the first clinical psychology department of Xi′an municipal mental health center from August 2014 to October 2017 were selected and divided into the observation group and control group by using the random number table method.The observation group was given escitalopram,while the control group was treated with mirtazapine,and the treatment cycle was 2 months.Before and after treatment,the degree of depression was observed with the Hamilton Depression Scale（HAMD）,and the effect of drugs on sleep quality was evaluated by the Pittsburgh Sleep Quality Index（PSQI）,the effect of drugs on suicide risk of the patients were evaluated by calculating total scores of suicide attitude（SA）and suicidal tendency scores.Results Compared with before treatment,the HAMD scores after treatment in the two groups were significantly decreased,the difference was statistically significant（P〈0.05）.Compared with the control group,the PSQI score in the observation group was significantly lower than that in the control group,the SA score in the observation group was higher than that in the control group,while the suicide tendency score was lower,the difference was statistically significant（P〈0.05）.Conclusion Escitalopram can effectively improve the sleep disorder in the patients with major depression complicating anxiety,increases the sleep quality,reduces the suicide risk,and has higher safety and better clinical results.