氯胺酮依赖患者抑郁症状的因子结构维度分析

Factor Structural Dimension Analysis of Depressive Symptoms in Ketamine Dependent Patients

目的:探讨氯胺酮依赖患者的汉密尔顿抑郁量表-17(HAMD-17)因子结构维度,并与单、双相抑郁症患者进行比较。方法:共入组342例氯胺酮依赖患者和131例单、双相抑郁患者(包括70例单相抑郁患者和61例双相抑郁发作患者),采用HAMD-17量表评估其抑郁症状。应用主成分因子分析法分析两组患者HAMD-17量表的因子结构特点和异同。结果:氯胺酮依赖患者组HAMD-17总分显著低于单、双相抑郁患者组,差异有统计学意义(P<0.05),HAMD-17量表中的各个条目在两组患者间的得分趋势较相似。主成分因子分析显示,氯胺酮依赖患者组HAMD-17量表呈4因子结构(躯体化焦虑、抑郁、睡眠障碍和因子4),其解释的变异性百分比为54.5%;单、双相抑郁患者组则呈5因子结构(躯体化焦虑、抑郁、睡眠障碍、因子4和因子5),其解释的变异性百分比为61.5%。躯体化焦虑因子、抑郁因子和睡眠障碍因子是两组患者抑郁症状的主要因子。结论:本研究结果初步揭示了HAMD-17量表在氯胺酮依赖患者和单、双相抑郁症患者中的因子结构的异同点。

Objective:To explore the factor structure dimensions of HAMD-17 in ketamine dependent patients,and compare with dimensions from unipolar and bipolar depressive patients.Methods:The depressive symptoms of 342 ketamine dependent patients,131 patients with unipolar depressive or bipolar disorder(BD)were evaluated by the HAMD-17.The factor structures of the HAMD-17 in the two groups were determined by principal component factor analysis with varimax rotation.Results:The total score of HAMD-17 in ketamine dependent patients was significantly lower than that in unipolar and bipolar depression patients(P<0.05).The scores of each item in HAMD-17 scale were similar between the two groups.Principal component factor analysis showed that the HAMD-17 scale of ketamine dependent patients had a four-factor structure(somatization anxiety,depression,sleep disorders and factor 4),which explained 54.5%of the variability.The patients with unipolar and bipolar depression showed a fivefactor structure(somatization anxiety,depression,sleep disorders,factor 4 and factor 5),which explained 61.5%of the variability.Somatization anxiety factor,depression factor and sleep disorder factor were the main factors of depressive symptoms in the two groups.Conclusion:Our results could provide some degrees of insight into the similarities and differences in the factor structure of the depressive symptoms for these two groups.