抑郁障碍共病焦虑障碍临床症状调查及相关因素分析

Clinical symptoms investigation and related factors analysis of comorbid anxiety disorder in depressive disorder

目的探讨抑郁障碍共病焦虑障碍的临床特征,分析其相关因素。方法选择2016年3月—2017年12月我院门诊符合ICD-10诊断标准,汉密顿抑郁量表HAMD≥18分的86例抑郁障碍患者,依据是否伴焦虑障碍分为2组,进行一般情况问卷调查和量表筛查,对其临床特征进行分析,找出抑郁障碍共病焦虑障碍的影响因素。结果单因素分析发现2组患者在年龄、起病年龄、居住地、精神疾病家族史方面差异有统计学意义(P<0.05);在性别、文化程度、家庭环境、发病诱因等方面无统计学差异(P>0.05)。2组的HAMD总分和HAMA总分差异有统计学意义(P<0.01),HAMD各因子中,在焦虑/躯体化、认知障碍、日夜变化、激越等方面差异有统计学意义(P<0.01),共病组明显高于非共病组,2组在体重减轻、迟滞、睡眠障碍、绝望感等方面差异无统计学意义(P>0.05);在HAMA各因子中,精神性焦虑和躯体性焦虑在2组中均有统计学差异,共病组明显高于非共病组(P<0.01)。多因素分析发现:年龄、居住地、起病年龄、精神病家族史、HAMD总分、HAMA总分对抑郁障碍共病焦虑障碍有显著影响(P<0.05),为其危险因素。结论抑郁障碍共病焦虑障碍是常见病,患者具有症状重、病程长、社会功能损害明显、预后差的特征,需引起临床工作者重视。

Objective To explore the clinical features of comorbid anxiety disorder of depressive disorder and analyze its related factors. Methods Select 86 patients with depressive disorder from March 2016 to December 2017 who met the ICD-10 diagnostic criteria in our hospital and the Hamilton Depression Scale(HAMD)≥18 for general questionnaire and scale screening,and analy the clinical features to find out the influencing factors of comorbid anxiety disorder. Results The Univariate analysis showed that there were statistically significant differences in age,onset age,place of residence,and family history of mental illness between the two groups patients(P<0.05).There were no significance in gender,education level,family environment,and cause of the disease,P>0.05. Furthermore, there was a statistically significant difference between the total score of HAMD and the total score of HAMA in the two groups(P=0.000).The difference was statistically significant among the factors of HAMD,anxiety/somatization,cognitive impairment,day and night changes,agitation(P<0.01),and the comorbidity group was significantly higher than the non-comorbidity disease group. There was no significant difference in weight loss,hysteresis,sleep disturbance,and sense of despair between the two groups.Among the HAMA factors,the mental anxiety and somatic anxiety were statistically significant in both groups,and the comorbidity group was significantly higher than the non-comorbidity disease group.③Multivariate analysis found that age,place of residence,age at onset,family history of psychosis,total score of HAMD,and total score of HAMA 6 had significant effects on comorbid anxiety disorder of depressive disorder(P<0.05). Conclusion Depressive disorder comorbid anxiety disorder is a common disease. These patients have the characteristics of serious symptoms,long course of disease,obvious social function damage and poor prognosis,which need to be paid attention to by clinicians.