双相和单相抑郁障碍患者的临床特征及心理社会支持治疗效果分析

Clinical characteristics and effect of psychosocial support therapy in patients with bipolar and unipolar depressive disorder

目的探讨双相和单相抑郁障碍患者的临床特征及心理社会支持治疗效果。方法回顾性分析诊断为单相抑郁的患者40例和双相抑郁的患者40例的临床资料,对比两组患者临床特征及两组患者对心理社会支持治疗的反应效果。结果双相抑郁组患者与单项抑郁组比较,首次发病年龄早、发作史高、首诊符合率低、病程长(P<0.05)。双相抑郁组激越、精神病性症状、合并躯体共病发病率要高于单相抑郁患者(P<0.05);自杀意念或行为、合并焦虑障碍发病率低于单相抑郁组(P<0.05)。干预后两组患者HAMD、UCLA评分均较干预前降低(P<0.05),LSI评分较干预前升高(P<0.05);单相抑郁组干预后HAMD、UCLA评分低于双相抑郁组(P<0.05),LSI评分高于双相抑郁组(P<0.05)。结论双相抑郁发作无明显诱因,而且发作较为频繁,首次发病年龄早,心理社会支持治疗效果较差,以后需要加强其心理干预治疗。

Objective To explore the clinical characteristics and effects of psychosocial support therapy in patients with bipolar and unipolar depressive disorder. Methods The clinical data of 40 patients with unipolar depression(unipolar depression group) and 40 patients with bipolar depression(bipolar depression group) were retrospectively analyzed. Results The patients in bipolar depression group had earlier onset age, higher history of onset, lower coincidence rate of first visit and longer course of disease compared with those in unipolar depression group(P<0.05). The incidence rates of agitation, psychotic symptoms and somatic comorbidity in bipolar depression group were significantly higher than those in unipolar depression group(P<0.05). The incidence rates of suicidal ideation or behavior and anxiety disorder in unipolar depression group were significantly higher than those in bipolar depression group(P<0.05). After psychosocial support therapy, the scores of HAMD, UCLA in both groups decreased compared with those before treatment and the score of LSI increased compared with that before treatment(P<0.05). After treatment, the scores of HAMD and UCLA in unipolar depression group were significantly lower than those in bipolar depression group;the score of LSI in unipolar depression group was significantly higher than that in bipolar depression group(P<0.05). Conclusion Bipolar depressive episode has no obvious inducement, with more frequent onset, younger first onset age and poor effect of psychosocial support therapy, needing to strengthen the psychological intervention treatment later.