非典型抑郁患者临床特征、季节性特征及影响因素分析

Clinical characteristics,seasonal characteristics and related factors in patients with atypical depression

目的了解非典型抑郁患者的临床特征、季节性特征及影响因素。方法纳入2021年1~8月在北京大学第六医院门诊就诊的抑郁患者203例,采用一般情况调查表、抑郁症状量表(inventory of depressive symptomatology self-report,IDS-SR30)、季节性行为模式调查表(seasonal pattern assessment questionnaire,SPAQ)对临床特征及季节性特征进行调查,通过抑郁症状量表得分划分为非典型抑郁(atypical depression,AD)和其他类型抑郁(non-atypical depression,non-AD)。采用SPSS 26.0统计软件进行t检验、非参数检验和Logistic回归分析。结果抑郁患者中非典型抑郁占比为36.0%(95%CI=29.3%~42.6%)。非典型抑郁组抑郁症状量表得分为(41.59±10.59)分,其他类型抑郁组抑郁症状量表得分为(36.08±13.17)分,两组差异有统计学意义(t=3.062,P<0.05)。非典型抑郁组总体季节性得分为6(3,9)分,有季节性特征占比为17.8%,其他类型抑郁组总体季节性得分为5(3,8)分,有季节性特征为14.6%,两组总体季节性得分及季节性特征均差异无统计学意义(Z=0.389,χ^(2)=0.359,均P>0.05)。女性(β=1.08,OR=2.95,95%CI=1.32~6.59,P<0.05)、自我贬低(β=0.82,OR=2.27,95%CI=1.12~4.59,P<0.05)、精神运动迟滞(β=0.93,OR=2.54,95%CI=1.33~4.85,P<0.05)的抑郁患者更易被诊断为非典型抑郁,而情绪随时间变化(β=-0.94,OR=0.39,95%CI=0.19~0.81,P<0.05)更容易被诊断为其他类型抑郁。结论在抑郁患者中,女性、自我贬低、精神活动迟滞以及不明显的情绪变化可以帮助识别和区分非典型抑郁。

Objective To know the clinical characteristics,seasonal pattern and influencing factors of atypical depression(AD)patients.Methods A total of 203 depressed outpatients of Peking University Sixth Hospital from January 2021 to August 2021 were included.They were assessed with demographic questionnaire,inventory of depressive symptomatology self-report(IDS-SR30)and seasonal pattern assessment questionnaire(SPAQ).According the score of IDS-SR30,all patients were classified as atypical depression(AD)and non-atypical depression(non-AD).The data were analyzed by t-test,non-parametric test and Logistic regression using SPSS 26.0 software.Results The prevalence of AD among depressed patients was 36.0%(95%CI=29.3%-42.6%).The IDS-30 score of the AD group was(41.59±10.59),and IDS-30 score of the non-AD group was(36.08±13.17),and the difference between the two groups was statistically significant(t=3.062,P<0.05).The global seasonal score of the AD group was 6(3,9),and 17.8%of the AD group had seasonal pattren.The global seasonal score of the non-AD group was 5(3,8),and 14.6%of the non-AD group had seasonal pattern.There was no significant difference in the global seasonal score and the proportion of seasonal pattern between the two groups(Z=0.389,χ^(2)=0.359,P>0.05).Depression patients who were females(β=1.08,OR=2.95,95%CI=1.32-6.59,P<0.05),low self-evaluation(β=0.82,OR=2.27,95%CI=1.12-4.59,P<0.05)and psychomotor retardation(β=0.93,OR=2.54,95%CI=1.33-4.85,P<0.05)were more likely to be diagnosed as AD,and depression patients having mood variation(β=-0.94,OR=0.39,95%CI=0.19-0.81,P<0.05)were more likely to be diagnosed as non-AD.Conclusion Women,low self-evaluation,psychomotor retardation and unobvious mood variation can predict and help to diagnose atypical depression in depressed patients.