老年抑郁症住院患者复发影响因素的回顾性分析

Influencing factors of relapse in late-life depression

目的:比较老年首发与复发抑郁症住院患者的临床特征,分析老年抑郁症复发的影响因素。方法:回顾性分析380例老年首发和复发抑郁症住院患者的临床资料,比较两组患者一般资料、临床特征资料及常规实验室指标差别,根据不同类型数据分别进行单因素分析(t检验、卡方检验和秩和检验)以及多因素logistic回归分析,分析老年抑郁症复发的影响因素。结果:380例研究对象中复发164例(43.16%)纳入复发组,首发216例(56.84%)纳入首发组,多因素logistic回归分析结果显示病程长(OR=1.104,95%CI:1.070~1.140)、有自杀史(OR=1.903,95%CI:1.054~3.435)、活动减少(OR=2.847,95%CI:1.114~7.278)、进食减少(OR=2.800,95%CI:1.576~4.974)是老年抑郁症患者复发的危险因素,而服药依从性好(OR=0.542,95%CI:0.338~0.867)是老年抑郁症患者复发的保护因素。结论:老年抑郁症住院患者中复发病例占比高,应重点关注病程长、有自杀史、服药依从性差、活动和进食量减少的患者,对影响因素应进行针对性干预,以预防老年抑郁症复发。

Objective:To explore the influencing factors of late-life depression(LLD)re-lapse.Methods:The clinical data of 380 senile inpatients with first-episode and recurrent depression were retrospectively analyzed,and the differences in general data,clinical characteristics and routine laboratory indicators were compared between two groups.Univariate analysis(T test,Chi-square test and rank-sum test)and multivariate logistic regression analysis were performed according to different types of data.Results:Among 380 subjects,164 recurrent cases(up to 43.16%)were included in the recurrent group,and 216 first-episode cases(56.84%)were included in the first-episode group.Multivariate logistic regression analysis showed that the long course of disease(OR=1.104,95%CI:1.070~1.140),a history of suicide(OR=1.903,95%CI:1.054~3.435),decreased activity(OR=2.847,95%CI:1.114~7.278),decreased eating(OR=2.800,95%CI:1.576~4.974)might be risk factors for relapse in LLD,and good medication compliance(OR=0.542,95%CI:0.338~0.867)might be a protective factor for relapse in LLD.Conclusion:There is a high proportion of recurrent cases in the elderly inpatients with depression.Patients with long course of disease,suicide history,poor medication compliance,and decreased activity and food intake should be paid attention to.Targeted interventions should be carried out to prevent the recurrence of late-life depression.