混合特征对抑郁发作患者复发影响的1年随访

One-year follow-up study of mixed features as risk factors for relapses in patients with a major depressive episode

目的:探索抑郁发作患者复发的危险因素及混合特征对抑郁发作患者复发的影响。方法:2015年8月1日-2017年9月30日,在北京某三级甲等精神专科医院选取符合DSM-Ⅳ标准的抑郁发作患者357例进行基线测查并在基线后1年进行随访评估其复发情况。基线测查包括收集患者一般人口学资料、既往治疗情况和是否具有混合特征及其数目,采用汉密顿抑郁量表、杨氏躁狂量表等量表评估病情。单因素初步分析混合特征及其他因素对抑郁发作患者复发风险的影响,多因素logistic回归分析进一步分析复发的影响因素。结果:31.1%的患者一年内复发,多因素logistic回归分析显示,12月末的服药依从性是抑郁发作患者复发的保护因素(OR=0.53,95%CI:0.28~0.99),既往发病次数(OR=1.19,95%CI:1.01~1.39)、具有混合特征的个数(OR=1.54,95%CI:1.19~2.00)是抑郁发作复发的危险因素。结论:既往发病次数及抑郁发作时具有的混合特征个数是患者疾病复发的危险因素。

Objective:To explore the risk factors of relapses and the influence of mixed features mixed the risk factors on relapses in patients with a major depressive episode.Methods:A total of 357 patients met the diagnosis of depressive episode according to DSM-Ⅳ criteria were enrolled in this research,and were followed up for assess­ment 1 yea after baseline.General demographic data and relevant clinical characteristics of the patients were col­lected.The Hamilton depression scale(HMAD-17),Young Mania Rating Scale(YMRS)and other scales were used to evaluate the conditions of the patients.With the recurrence as the evaluation indicator,the related factors af­fecting the relapse were analyzed by using multivariate logistic regression analysis.Results:The relapse rate in pa­tients was 31.1%after one yea.Multivariate logistic regression analysis showed that medication adherence at the end of 12 months(OR=0.53,95%CI:0.28-0.99)was a protective factor against the recurrence,and on the contrary,the number of episodes of depression(OR=1.19,95%CI:1.01-1.39)and the number of mixed features(OR=1.54,95%CI:1.19-2.00)were risk factors for the relapses of major depressive episodes.Conclusion:The number of episodes of depression and the number of mixed features may be the risk factors for relapses in patients with major depressive episodes.