强迫症住院患者抑郁水平及诊治状况的回顾性分析

Retrospective analysis of depression level,diagnosis and treatment of inpatients with obsessive-compulsive disorder

目的:分析强迫症住院患者的临床特征、治疗状况及抑郁水平影响因素。方法:回顾性调查2012年至2021年192例强迫症住院患者,以汉密尔顿抑郁量表(HAMD)划界分(HAMD≥20分)将患者分为抑郁组与非抑郁组。应用HAMD与汉密尔顿焦虑量表(HAMA)评分评估两组抑郁与焦虑情况,应用多元逐步线性回归方程分析强迫症住院患者抑郁的影响因素。结果:强迫症患者以未婚(64.6%)、男性(62.5%)为主,入院前71.4%患者曾多次就医,且患者共病各类精神障碍26例(12.00%),其中抑郁症9例(39.13%)、精神分裂症7例(30.43%)、抽动障碍5例(21.74%)、焦虑障碍2例(8.70%)、双相障碍2例(8.70%)、其他精神障碍1例(4.34%)。116例具有HAMA、HAMD评分的患者中,抑郁组61例,非抑郁组55例。抑郁组HAMA(t=6.627,P<0.01)与HAMD(t=11.835,P<0.01)评分明显高于非抑郁组,差异具有统计学意义。Logistic回归分析结果显示,焦虑是强迫症患者抑郁的影响因素。结论:强迫症住院患者焦虑、抑郁发生率高,且焦虑的存在对抑郁状态产生影响,是影响患者是否抑郁的高危因素。

Objective:To analyze the clinical characteristics,treatment and the influencing factors of depression level of inpatients with obsessive-compulsive disorder.Method:192 inpatients with obsessive-compulsive disorder from 2012 to 2021 were investigated retrospectively.The patients were divided into depression group and non-depression group with cutoff score of Hamilton Depression Scale(HAMD)(HAMD≥20).Depression and anxiety were evaluated by HAMD and Hamioton Anxiety Scale(HAMA).The influencing factor affecting the level of depression was analyzed with the multiple stepwise linear regression equation.Results:The patients hospitalized with obsessive-compulsive disorder were predominantly unmarried(64.6%)and male(62.5%)patients.71.4%of the patients had sought medical care several times before admission,and patients had 26 cases(12.00%)of various types of psychiatric disorders,including 9 cases of depression(39.13%),7 cases of schizophrenia(30.43%),5 cases of tic disorder(21.74%),2 cases of anxiety disorder(8.70%),2 cases of bipolar disorder(8.70%),and 1 case in other psychiatric disorders(4.34%).Of 116 inpatients with HAMA and HAMD scores,61 were in the depression group and 55 were in the non-depression group.HAMA(t=6.627,P<0.01)and HAMD(t=11.835,P<0.01)scores in the depression group were higher than those in the non-depression group,the differences were statistically significant.The results of Logistic regression analysis showed that anxiety was the influencing factor of depression in patients with obsessive-compulsive disorder.Conclusion:The high prevalence of anxiety and depression in inpatients with obsessive-compulsive disorder and the presence of anxiety has an impact on the depressive state and is a high risk factor for whether the patient is depressed.