重性抑郁障碍伴酒精使用障碍患者临床特征及应对方式研究

Study on the clinical features and coping styles of comorbidity alcohol use disorder in major depressive disorder

目的调查重性抑郁障碍伴酒精使用障碍患者的临床特征及应对方式。方法以诊断为重性抑郁障碍的住院患者为研究对象,根据是否伴酒精使用障碍分为共病组与非共病组。采用一般情况调查表调查患者的临床特征及冲动、外走、自杀、自伤行为,应对方式问卷调查患者的应对方式。结果纳入重性抑郁障碍患者162例,其中共病酒精使用障碍44例(27.2%)。共病组较非共病组的患者,男性居多,有嗜酒家族史者多,家庭关系不和睦,起病形式以亚急性为主,自伤及自杀行为更多,多采用自责的应对方式而较少采用求助的应对方式(均P<0.05)。多因素logistic回归分析显示男性(OR=8.636,P<0.001)、家庭关系不和睦(以"一般"为参照,OR=6.043,P=0.007)、有自杀行为(OR=3.292,P=0.037)与共病酒精使用障碍相关联。结论重性抑郁障碍伴酒精使用障碍患者发生自杀行为风险更高,更多采用自责的应对方式,应引起临床医生重视。

Objective To investigate the clinical features and coping styles of patients with major depressive disorder comorbid with alcohol use disorder.Methods The Statistical Diagnostic Manual of Mental Disorders,Fifth Edition(DSM-5)was used as the diagnostic criteria.The inpatients diagnosed as major depressive disorder were selected.They were divided into co-morbid and non-co-morbid groups depending on whether alcohol use disorder was combined.The general information questionnaire was used to investigate clinical characteristics of patients and various risks,and the coping style.Results Among the 162 subjects with major depressive disorder,44 patients(27.2%)had comorbidity alcohol use disorder.Patients in the co-morbid alcohol use disorder group were more likely to be male,to have a family history of alcoholism and poor family relationships(P<0.05).In addition,they had predominantly subacute onset with self-injury and suicidal behavior,and coped more with self-blame and less with help(P<0.05)compared with those without co-morbid alcohol use.Multifactorial logistic regression analysis showed that male,an unhappy family relationship,and suicidal behaviors were associated with co-morbid alcohol use disorders(P<0.05).Conclusion Patients with major depressive disorder comorbid with alcohol use disorder are more likely to use self-blaming coping styles and are at higher risk for suicidal behavior,which should be brought to the attention of clinicians.