抑郁症快感缺失的特点及对症状严重程度和短期预后的影响

The traits of anhedonia of depression and its effects on symptoms severity and short-term clinical outcome

目的探讨抑郁症快感缺失不同成分的特点及其对抑郁症状严重程度和短期疗效的影响。方法采用时间性快感体验量表(TEPS)、汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)对72例住院抑郁症患者及性别、年龄匹配的72例健康对照者分别在基线及治疗2周后进行评估,以HAMD总分在治疗前后的减分率作为主要疗效指标。结果抑郁症患者在TEPS-消费性具体因子分、TEPS-消费性抽象因子分、TEPS-期待性抽象因子分、TEPS-期待性具体因子分显著低于健康对照组,差异均有统计学意义(P<0.05)。相关性分析发现,TEPS-期待性具体与基线HAMA呈显著负相关(r=-0.236,P<0.05)。对患者治疗2周的HAMD-17减分率进行逐步回归分析发现,TEPS-消费性抽象的贡献显著,解释HAMD-17减分率变异的12.1%(R^2=0.121)。结论抑郁症患者有明显的快感缺失,而较高的快感体验(TEPS-消费性抽象)可能与较轻的临床焦虑症状和较好的临床疗效相关。

Objective To explore the traits of anhedonia components of depression and its effects on symptoms severity and short-term clinical outcome.Methods The Temporal Experience of Pleasure Scale(TEPS),the Hamilton Depression Scale(HAMD-17),and the Hamilton Anxiety Scale(HAMA)were used to measure 72 patients with depression at baseline and treatment after 2 weeks,and 72 gender and age-matched healthy controls.The reduction rate of HAMD total scores before and after treat was used as the main efficacy indicator.Results TEPS-contextual consummatory scores,TEPS-abstract consummatory scores,TEPS-abstract anticipatory scores,TEPS-contextual anticipatory scores were significantly lower than control group,the differences were statistically significant(P<0.05).Correlation analysis found that TEPS-abstract anticipatory scores were significantly negatively correlated with the severity of anxiety(r=-0.236,P<0.05).The reduction rate of HAMD-17 in patients with 2 weeks of treatment was used with stepwise regression analysis found that the significant contribution of TEPS-contextual consummatory,and explained the reduction rate variables 12.1%(R~2=0.121)of HAMD-17.Conclusion Depression patients have obvious anhedonia,higher pleasure experience(TEPS-contextual consummatory)may be related to mild clinical anxiety symptoms and better clinical efficacy.