老年期与非老年期抑郁症症状特点比较

Comparison of Symptomatic Feature of Senile Depression and Younger Than 60 Years Depression

目的 :比较老年期与非老年期抑郁症的临床症状特点。方法 :将 12 6例首次发病的单相抑郁症患者分为 2组 ,其中 6 3例 >6 0岁者为老年组 ,6 3例 <6 0岁者为非老年组。在入院时和住院 1个月时评定汉密尔顿抑郁量表 ,并比较治疗前后组内因分子的变化。同时对发病诱因、伴发躯体疾病及抑郁症状条目进行比较。结果 :老年组与非老年组的自杀意念 (分别为 4 5例 ,2 4例 )、疑病 (39例 ,2 0例 )、偏执症状 (2 0例 ,4例 )、焦虑 (4 8例 ,2 8例 )、自杀行为 (30例 ,13例 )、心境抑郁 (4 6例 ,5 9例 )、迟缓 (2 8例 ,4 5例 )、睡眠障碍 (4 8例 ,6 1例 )、记忆力减退 4 2例 ,18例 )的差异有非常显著性 (P <0 0 1)、激越 (2 6例 ,15例 ) ,昼重夜轻 (13例 ,2 4例 )、胃肠道症状 (2 2例 ,10例 )的差异有显著性 ,焦虑 /躯体化 [(8 4± 2 4 )分 ,(4 9± 2 0 )分 ]、认知障碍 [(5 9± 2 8)分 ,(3 9± 1 8)分 ]的差异有显著性 (P <0 0 5 ) ;伴发躯体疾病 (4 8列 ,17例 )的差异有非常显著性 (P <0 0 1) ,发病诱因 (2 3例 ,2 8例 )的差异无显著性 (P >0 0 5 )。用氟西汀或帕罗西汀 2 0mg/d治疗 1个月后 ,2组组内抑郁症状的比较 ,老年组各症状的差异无显著性 (P >0 0 5 ) ;非老年组焦虑 /躯体化 [(4 9± 2 0 )分 ,

Objective:To compare the clinical symptomatic features of senile depression and younger than 60 years depression.Methods:126 cases who meet the chinese classification and Diagnostic criteria of Mental Disorders,2nd revised edition for early-onset unipolar depression were collected in the study.63 of the 126 cases(older than 60 years)were designed as research group.the other 63(younger than 60 years),were in the control group.At admission and after one month of hospitalization,the Hamilton Rating scales for depression(HAMD)was assessed in all patients and then total and factors of the HAMD were analyzed and compared.The predisposing factors,concomitant somatic diseases and symptoms of depression were also analyzed.Results:there were significant differences or extremely significant differences in suicidal ideas(45 cases in observed group to 24 cases in control group),hypochondria(39 cases to 20 cases),paranoid symptoms(20 cases to 4 cases),anxiety(48 cases to 28 cases),agitation(26 cases to 15 cases),suicidal action(30 cases to 13 cases),day heavy night light(13 cases to 24 cases),gastrointestinal tract symptoms(22 cases to 10 cases),poor memory(42 cases to 18 cases),points of anxiety/somatization(8.4±2.4 to 4.9±2.0)and congnition disorders(5.9±2.8 to 3.9±1.8),( P <0.05)and extremely significant differences in concomitant somatic diseases(48 cases to 17 cases)( P <0.01),but no significant difference in the predisposing factors(23 cases to 28 cases)( P >0.05).when the cases were treated with prozac or paroxetine 20mg/day for one month,the symptomatic syndromes did not chang significantly after treatment( P >0.05)in the research group,but there were significant difference( P <0.05)in the points of anxiety/somatization(4.9±2.0 before treatment to 2.1±1.5 after treatment)and day-night-changing-syndromes(1.7±0.9 to 0.5±0.6),and significant difference in the points of weight change(1.0±1.0 to 0.4±0.6)in the control group,Conclusion:The senile depression has its own clinical symptomatic features and the effect of treatment is not good.