中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
25期
1760-1763
,共4页
吴恒趋%张瑛%李焰生%朱莹%沈沸
吳恆趨%張瑛%李燄生%硃瑩%瀋沸
오항추%장영%리염생%주형%침비
医院,综合%抑郁%临床特征
醫院,綜閤%抑鬱%臨床特徵
의원,종합%억욱%림상특정
Hospital,general%Depression%Clinical characteristics
目的 分析综合医院神经内科专病门诊患者抑郁状态的临床特点.方法 对2005年10月至2009年2月在上海交通大学附属仁济医院失眠与神经症专病门诊就诊患者进行连续性前瞻性登记,收集人口学等资料、评估26项躯体症状、应用Hamilton抑郁量表(HDRS17)进行评分并采用病例对照方法分析抑郁状态患者的临床特点.结果 596例患者中,抑郁状态347例(58.1%),汉密尔顿抑郁量表(HDRS-17)平均分数为21.9±3.4,以轻、中度抑郁为主.抑郁患者情感症状诉说率低,情绪低落146例(41.2%)、兴趣减退161例(46.4%),有2项症状者108例(31.3%);体力劳动者、受教育程度低下、婚姻状况差、经济状况差、不规律的生活方式、既往有躯体疾病者易出现抑郁;抑郁组患者常见躯体症状依次为早醒218例(76.0%)、入睡困难254例(73.2%)、记忆力差219例(63.1%)、疲乏无力181例(52.2%)、心悸179例(51.6%)、头晕170例(49.0%)、头痛160例(46.1%)、胸闷140例(40.3%);平均主诉的躯体症状个数为(6.9±2.8)个;具有多个躯体症状主诉者(躯体症状主诉≥4个)为322例(92.8%);相关分析显示躯体症状个数与抑郁相关.结论 综合医院神经内科专病门诊抑郁状态患者躯体症状突出.
目的 分析綜閤醫院神經內科專病門診患者抑鬱狀態的臨床特點.方法 對2005年10月至2009年2月在上海交通大學附屬仁濟醫院失眠與神經癥專病門診就診患者進行連續性前瞻性登記,收集人口學等資料、評估26項軀體癥狀、應用Hamilton抑鬱量錶(HDRS17)進行評分併採用病例對照方法分析抑鬱狀態患者的臨床特點.結果 596例患者中,抑鬱狀態347例(58.1%),漢密爾頓抑鬱量錶(HDRS-17)平均分數為21.9±3.4,以輕、中度抑鬱為主.抑鬱患者情感癥狀訴說率低,情緒低落146例(41.2%)、興趣減退161例(46.4%),有2項癥狀者108例(31.3%);體力勞動者、受教育程度低下、婚姻狀況差、經濟狀況差、不規律的生活方式、既往有軀體疾病者易齣現抑鬱;抑鬱組患者常見軀體癥狀依次為早醒218例(76.0%)、入睡睏難254例(73.2%)、記憶力差219例(63.1%)、疲乏無力181例(52.2%)、心悸179例(51.6%)、頭暈170例(49.0%)、頭痛160例(46.1%)、胸悶140例(40.3%);平均主訴的軀體癥狀箇數為(6.9±2.8)箇;具有多箇軀體癥狀主訴者(軀體癥狀主訴≥4箇)為322例(92.8%);相關分析顯示軀體癥狀箇數與抑鬱相關.結論 綜閤醫院神經內科專病門診抑鬱狀態患者軀體癥狀突齣.
목적 분석종합의원신경내과전병문진환자억욱상태적림상특점.방법 대2005년10월지2009년2월재상해교통대학부속인제의원실면여신경증전병문진취진환자진행련속성전첨성등기,수집인구학등자료、평고26항구체증상、응용Hamilton억욱량표(HDRS17)진행평분병채용병례대조방법분석억욱상태환자적림상특점.결과 596례환자중,억욱상태347례(58.1%),한밀이돈억욱량표(HDRS-17)평균분수위21.9±3.4,이경、중도억욱위주.억욱환자정감증상소설솔저,정서저락146례(41.2%)、흥취감퇴161례(46.4%),유2항증상자108례(31.3%);체력노동자、수교육정도저하、혼인상황차、경제상황차、불규률적생활방식、기왕유구체질병자역출현억욱;억욱조환자상견구체증상의차위조성218례(76.0%)、입수곤난254례(73.2%)、기억력차219례(63.1%)、피핍무력181례(52.2%)、심계179례(51.6%)、두훈170례(49.0%)、두통160례(46.1%)、흉민140례(40.3%);평균주소적구체증상개수위(6.9±2.8)개;구유다개구체증상주소자(구체증상주소≥4개)위322례(92.8%);상관분석현시구체증상개수여억욱상관.결론 종합의원신경내과전병문진억욱상태환자구체증상돌출.
Objective To evaluate the clinical characteristics of patients with depressive disorders at Department of Neurology in general hospitals.Methods A total of 596 consecutive patients with depressive symptoms,such as insomnia,or somatic symptoms were collected prospectively and those who were unable to answer the questionnaire were excluded.Data of demography and clinical characteristics were obtained from a questionnaire.The 17-item Hamilton depression rating scale (HDRS17) was used to identify the presence of depressive disorders. Case control method was employed to evaluate the clinical characteristics of patients with depressive disorders.Results Among all pailents,347 were diagnosed as depressive disorders (58.1%).The mean score of HDRS17 was 21.9±3.4.Fewer psychological symptoms were complained by patients with depressive disorder.The depressive mood was found in 146(41.2%),a loss of interost or pleasure 161 (46.4%) and depressive mood plus a loss of interest or pleasure 108 (31.3%).The factors of manual worker.lower education level.worse marital status.10wer economic statos,irregular lifestyle and coexisting medical conditions were associated with depressive disorders.The most frequent complaints of somatic symptoms were as follows:hard to fall asleep 254 (73.2%),early awakening 218(76.O%),poor memoory 219 (63.1%),fatigue 181(52.2%),palpitation 179(51.6%),dizziness 170(49.0%),headache 160(46.1%) and dyspnea 140 (40.3%).The mean number of somatic symptoms wag 6.87±2.78.The patients complaining of multiple somatic symptoms (≥4) was 322 (92.8%).The number of somatic symptoms was correlated with depressive disorders.Conclusions More minor depression and sonlatic symptoms are the main characteristics of patients with depressive disorder in general hospitals.
