CAJ | 학술논문

目的通过轻躁狂检测清单(HCL-32)测评结果甄别抑郁症中可能存在的双相障碍.方法对128例抑郁症患者应用软双相建议性诊断标准进行诊断,并比较软双相与非软双相抑郁症患者HCL-32的差异.结果 (1)128例抑郁症患者中,HCL-32评分0～19(5.7±4.7)分;(2)是否软双相抑郁者分别为15例和113例,HCL-32评分分别为[(9.4±6.7)分vs(5.2±4.2)分,t=3.40,P=0.001],是否宽松软双相抑郁者HCL-32评分分别为[(7.8±5.6)分vs(4.3±3.4)分,t=4.34,P=0.000],有无双相障碍家族史者HCL-32评分分别为[(9.2±6.8)分vs(5.4±4.4)分,t=2.39,P=0.018],有无躁狂转相史者HCL-32评分分别为[(8.6±7.3)分vs(5.3±4.3)分,t=2.05,P=0.043],有无环性人格或明显外向者HCL-32评分分别为[(8.4±5.7)分vs(5.3±4.4)分,t=2.58,P=0.011],有无旺盛性人格素质者HCL-32评分分别为[(9.0±6.7)分vs(5.0±3.9)分,t=3.90,P=0.000],有无边缘性人格者HCL-32评分分别为[(8.6±4.3)分vs(5.4±4.7)分,t=2.22,P=0.028],是否呈发作性病程者HCL-32评分分别为[(8.9±5.7)分vs(5.2±4.3)分,t=3.19,P=0.002];(3)男女患者HCL-32评分分别为[(4.3±3.7)分vs(6.6±5.1)分,t=2.87,P=0.005];(4)有抑郁症家族史者、有自杀家族史者、发病年龄≤25岁者、有非典型抑郁者、有精神运动抑制者、有精神病性抑郁者、有生物节律明显者HCL-32评分与对应组的差异无统计学意义;(5)HCL-32＞7分37例(28.9%),＞10分17例(13.3%),＞14分7例(5.5%),其中＞10分者所占比例与软双相所占比例接近.结论 HCL-32＞10分可能有助于在抑郁症患者中筛选诊断双相障碍.
목적 통과경조광검측청단(HCL-32)측평결과견별억욱증중가능존재적쌍상장애.방법 대128례억욱증환자응용연쌍상건의성진단표준진행진단,병비교연쌍상여비연쌍상억욱증환자HCL-32적차이.결과 (1)128례억욱증환자중,HCL-32평분0～19(5.7±4.7)분;(2)시부연쌍상억욱자분별위15례화113례,HCL-32평분분별위[(9.4±6.7)분vs(5.2±4.2)분,t=3.40,P=0.001],시부관송연쌍상억욱자HCL-32평분분별위[(7.8±5.6)분vs(4.3±3.4)분,t=4.34,P=0.000],유무쌍상장애가족사자HCL-32평분분별위[(9.2±6.8)분vs(5.4±4.4)분,t=2.39,P=0.018],유무조광전상사자HCL-32평분분별위[(8.6±7.3)분vs(5.3±4.3)분,t=2.05,P=0.043],유무배성인격혹명현외향자HCL-32평분분별위[(8.4±5.7)분vs(5.3±4.4)분,t=2.58,P=0.011],유무왕성성인격소질자HCL-32평분분별위[(9.0±6.7)분vs(5.0±3.9)분,t=3.90,P=0.000],유무변연성인격자HCL-32평분분별위[(8.6±4.3)분vs(5.4±4.7)분,t=2.22,P=0.028],시부정발작성병정자HCL-32평분분별위[(8.9±5.7)분vs(5.2±4.3)분,t=3.19,P=0.002];(3)남녀환자HCL-32평분분별위[(4.3±3.7)분vs(6.6±5.1)분,t=2.87,P=0.005];(4)유억욱증가족사자、유자살가족사자、발병년령≤25세자、유비전형억욱자、유정신운동억제자、유정신병성억욱자、유생물절률명현자HCL-32평분여대응조적차이무통계학의의;(5)HCL-32＞7분37례(28.9%),＞10분17례(13.3%),＞14분7례(5.5%),기중＞10분자소점비례여연쌍상소점비례접근.결론 HCL-32＞10분가능유조우재억욱증환자중사선진단쌍상장애.
Objective To assess results of the Hypomania Check List-32 (HCL-32) in Chinese depression patients for discriminating possible bipolar depression. Methods Totally 128 patients with depression meeting diagnostic criteria of depression in CCMD-3 and DSM-Ⅳ was assessed with the HCL-32,and their general data also was collected (gender, age, age of first onset, duration, family history,personality and type of temperament, and psychopathology). And patients also were assessed with Chinese Advice Diagnostic Criteria of Soft Bipolar (CADCSB) and loose CADCSB ( Depression with family history of bipolar disorder, or depression with extra personality or hyperthymia or cyclothymia). Results The mean score of the HCL-32 in this samples was (5.7 ±4.7) with range of 19(highest)to 0. There were higher HCL-32 scores in 15 soft bipolar than 113 no-soft bipolar patients (9.4 ±6.7,5.2 ±4.2,t =3.40,P=0.001), in 50 loose CADCSB than 78 no-loose CADCSB patients (7.8 ±5.6,4.3 ±3.4,t =4.34,P =0.000) ,and in 9 depressive patients with bipolar family history ( 9.2 ± 6.8,5.4 ± 4.4, t = 2.39,P = 0.018 ), 9 depressive patients with switching history ( 8.6 ± 7.3,5.3 ± 4.3, t = 2.05, P = 0.043 ),17 depressive patients with cyclothymia or extra personality ( 8.4 ± 5.7,5.3 ± 4.4, t = 2.58, P = 0.011 ),22 depressive patients with hyperthymia ( 9.0 ± 6.7,5.0 ± 3.9, t = 3.90, P = 0.000 ), 11 depressive patients with borderline personality disorder(8.6 ±4.3,5.4 ±4.7,t =2.22,P =0.028), 17 depressive patients with intermittent episode (8.9 ±5.7,5.2 ±4.3 ,t =3.19,P =0.002) than their respective controls. The HCL-32 of male patients was significantly higher than that of female patients ( 4.3 ± 3.7,6.6 ± 5.1, t = 2.87,P =0.005 ). There was no difference in HCL-32 scores between patients with and without depression family history, patients with and without suicide family history, and ones with younger first onset age than older 25 years old, ones with and without atypical depression, patients with and without psychomotor retardation,patients with and without psychotic symptoms, and ones with and without biological rhythm. In all the patients, 37 were with HCL-32 score of 7 or over, 17 with 10 or over and 7 with 14 points or over. The rate of patients with HCL-32 score of 10 or over was similar to the rate of patients with soft bipolar in this sample.Conclusion The HCL-32 could be helpful to screen out possible bipolar disorder in depressive patients.