难治性抑郁症危险因素的对照研究

A study of the risk factors of refractory depression

目的 探讨难治性抑郁症的相关危险因素 ,为临床防治提供客观依据。方法 将 16 0例符合难治性抑郁症标准的抑郁症与同期的非难治性抑郁症进行 1∶1配比病例对照研究 ,应用条件Logistic回归分析方法处理数据。结果 多因素条件Logistic回归分析表明难治性抑郁症的危险因素是 :双相情感障碍 (OR= 3. 6 78,95 %CI:1. 80 5 7. 32 1) ,神经质 (OR =4 . 4 5 9,95 %CI :1. 790 10 . 889) ,伴有精神病性症状 (OR =4 .36 1,95 %CI :2 .183 8.4 10 ) ,情感疾病家族史 (OR =0 .36 7,95 %CI :0 .0 19 0 .916 ) ,一年内未及时治疗 (OR =0 .4 0 8,95 %CI :0 .2 0 7 0 .82 9)。结论 具有双相情感障碍、神经质、伴有精神病性症状、情感疾病家族史。

Objective To explore the risk factors of refractory depression and to provide the clinician with some indications for prevention and treatment .Methods A 1:1 matched case-controll study was carried out in including 160 cases and the same number of controls.A conditional logistic regression model was used for statistical analysis.Results Multivariate conditional logistic regression analysis showed that refractory depression was significantly related with five risk factors including bipolar disorder(OR=3.678,95%CI:1.805-7.321),neuroticism(OR=4.459,95%CI:1.790-10.889),with psychotic symptoms(OR=4.361,95%CI:2.183-8.410),family history of mood disorder(OR=0.367,95%CI:0.019-0.916),inadequate treatment within the first year(OR=0.408,95%CI:0.207-0.829).Conclusion Bipolar disorder,neuroticism,with psychotic symptoms,family history and inadequate treatment within first one year were main risk factors for refractory depression.