双相情感障碍抑郁发作治疗后的残留症状及其相关因素分析

Analysis of Residual Symptoms and Related Factors After Treatment of Depressive Episode of Bipolar Disorder

目的探讨并分析双相情感障碍(BD)患者抑郁发作治疗后的残留症状及其相关因素。方法选取2019年1月-2021年2月在本院治疗后的BD抑郁发作的患者65例,所有患者均采用杨氏躁狂评定量表(YMRS)与汉密顿抑郁量表(HAMD-17)进行评估,依据HAMD-17评分标准,量表评分总分≤7分为有残留症状,将患者分为有残留症状组(n=23)与无残留症状组(n=42)。回顾性分析两组患者基线资料,比较两组患者社会功能缺陷筛选量表(SDSS)评分,Logistic回归分析BD抑郁发作患者治疗后残留症状的相关因素。结果一般资料比较显示,两组年龄、发病年龄、病程、受教育年限、就业情况、BD类型等比较差异无统计学意义(P>0.05),两组在性别、婚姻状况、近2年发作次数、急性期伴睡眠障碍、YMRS评分、HAMD-17评分等维度相比较存在明显差异(P<0.05);有症状残留组SSDS中婚姻职能、对外界兴趣与关心、责任心和计划性等项目的评分明显高于无残留症状组(P<0.05);Logistic回归分析显示,男性、近2年发作次数>3次、YMRS评分与HAMD-17评分升高、急性期伴睡眠障碍为BD患者抑郁发作治疗后残留症状的影响因素(P<0.05)。结论BD患者性别、近2年发作次数、急性期伴睡眠障碍、YMRS评分、HAMD-17评分是影响抑郁发作治疗后是否残留症状的相关因素。

Objective To explore and analyze the residual symptoms and related factors in patients with bipolar disorder(BD)after treatment.Methods 65 patients with BD depression after treatment in our hospital from January 2019 to February 2021 were selected.All patients were evaluated with young's Mania Rating Scale(YMRS)and Hamilton Depression Scale(HAMD-17).According to the HAMD-17 scoring standard,the total score of the scale≤7 was residual symptoms,and the patients were divided into residual symptoms group(n=23)and no residual symptoms group(n=42).The baseline data of the two groups were analyzed retrospectively,the scores of social function deficiency screening scale(SDSS)were compared between the two groups,and the related factors of residual symptoms in patients with BD depression were analyzed by logistic regression.Results The baseline data showed that there was no significant difference between the two groups in age,age of onset,course of disease,years of education,employment and type of BD(P>0.05).There were significant differences between the two groups in gender,marital status,number of seizures in recent 2 years,acute sleep disorder,YMRS score and HAMD-17 score(P<0.05);The scores of marital function,interest and care for the outside world,sense of responsibility and planning in the symptomatic residual group were significantly higher than those in the non symptomatic residual group(P<0.05);Logistic regression analysis showed that gender,male,the number of episodes>3 in recent 2 years,the increase of YMRS score and HAMD-17 score,and sleep disorder in acute stage were the influencing factors of residual symptoms after treatment(P<0.05).Conclusion Gender,attack frequency in recent 2 years,acute phase with sleep disorder,YMRS score and HAMD-17 score of patients with BD are related factors affecting whether there are residual symptoms after treatment of depressive attack.