首发未治疗青少年抑郁症患者肥胖与抑郁严重程度的关系

The association of obesity with depressed severity in adolescent patients with first-episode untreated major depressive disorder

目的:探讨青少年抑郁症(major depressive disorder,MDD)患者肥胖的患病特点及其与抑郁严重程度之间的关系。方法:根据纳入标准和排除标准,共选取278例青少年抑郁症患者,收集一般人口学资料,采用24项汉密尔顿抑郁量表(24-item Hamilton depression scale,HAMD-24)评估抑郁严重程度。根据我国青少年体质量指数(body mass index,BMI)分类标准,将研究对象分为四组(消瘦组、正常组、超重组和肥胖组)。使用SPSS 26.0进行统计分析,组间比较分别采用Kruskal-Wallis检验和χ^(2)检验,采用Spearman相关分析BMI与HAMD-24总分、抑郁严重程度之间的关系。结果:278例青少年抑郁症患者中,体型异常率为32.4%(90/278),其中消瘦、超重、肥胖率分别为9.0%(25/278)、14.4%(40/278)、9.0%(25/278)。四组患者在性别(χ^(2)=17.018,P<0.001)、HAMD-24总分(H=9.427,P=0.024)、抑郁严重程度(H=8.508,P=0.037)上的差异有统计学意义。多重比较结果显示:与正常组相比,男性肥胖率较女性高(χ^(2)=13.631,P<0.001),肥胖组HAMD-24总分(Z=2.956,P=0.003)、抑郁严重程度(Z=2.832,P=0.005)更低。Spearman相关分析结果显示:BMI与HAMD-24总分呈负相关(r=-0.162,P=0.007)。结论:首发未治疗青少年抑郁症患者的肥胖率存在性别差异,肥胖患者较BMI正常患者抑郁程度更轻。

Objective To investigate the characteristics of obesity in adolescents with major depressive disorder(MDD)and its association with the depressed severity.Methods A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria.Their demographic data were collected and 24-item Hamilton depression scale(HAMD-24)was used to evaluate their severity of depression.According to the body mass index(BMI)classification standard of adolescents in China,all subjects were classified into four groups(wasting group,normal BMI group,overweight group and obesity group).SPSS 26.0 statistical software was used for data analysis.The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results Among 278 adolescents with MDD,the prevalence of body abnormality was 32.4%(90/278),among which wasting,overweight and obesity were 9.0%(25/278),14.4%(40/278)and 9.0%(25/278)respectively.There were statistically differences in gender(χ^(2)=17.018,P<0.001),HAMD-24 scores(H=9.427,P=0.024)and depressed severity(H=8.508,P=0.037)among the four groups.Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group,that was the prevalence of obesity in males was higher than that in females(χ^(2)=13.631,P<0.001),and the level in HAMD-24 scores(Z=2.956,P=0.003)and depressed severity(Z=2.832,P=0.005)was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores(r=-0.162,P=0.007).Conclusion There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD.And the obese patients are less depressed than those with normal BMI.