CAJ | 학술논문

目的：比较综合医院和精神专科医院抑郁障碍门诊中未识别出的双相障碍患者的临床特征及相关影响因素。方法：使用一般情况调查表和简明国际神经精神访谈（MINI）对综合医院和精神专科医院抑郁障碍门诊患者各50例进行调查，检出其中未被识别出的双相障碍患者，对其临床特征进行初步分析。结果：双相障碍的总检出率综合医院和精神专科医院之间差异无统计学意义（χ2＝2.38，P ＝0.123）；但在41~50岁年龄段精神专科医院的检出率高于综合医院（Z ＝2.11，P ＝0.035）。精神专科医院双相障碍的检出率与年龄（r ＝-0.46，P ＝0.001）和首发年龄（r ＝-0.37，P ＝0.008）的相关性具有统计学意义。综合医院和精神专科医院未识别出的双相障碍患者在年龄（t ＝2.43，P ＝0.020）和首发年龄（t ＝3.67，P ＝0.001）上的差异具有统计学意义。精神专科医院中未识别出的双相障碍更多的伴有精神病性症状（χ2＝3.99，P ＝0.046）。综合医院中未识别出的轻躁狂症状“目前发作”比率更高（χ2＝8.15， P ＝0.017）。结论：综合医院和精神专科医院抑郁障碍门诊患者中双相障碍的漏诊和误诊因素不同。
목적：비교종합의원화정신전과의원억욱장애문진중미식별출적쌍상장애환자적림상특정급상관영향인소。방법：사용일반정황조사표화간명국제신경정신방담（MINI）대종합의원화정신전과의원억욱장애문진환자각50례진행조사，검출기중미피식별출적쌍상장애환자，대기림상특정진행초보분석。결과：쌍상장애적총검출솔종합의원화정신전과의원지간차이무통계학의의（χ2＝2.38，P ＝0.123）；단재41~50세년령단정신전과의원적검출솔고우종합의원（Z ＝2.11，P ＝0.035）。정신전과의원쌍상장애적검출솔여년령（r ＝-0.46，P ＝0.001）화수발년령（r ＝-0.37，P ＝0.008）적상관성구유통계학의의。종합의원화정신전과의원미식별출적쌍상장애환자재년령（t ＝2.43，P ＝0.020）화수발년령（t ＝3.67，P ＝0.001）상적차이구유통계학의의。정신전과의원중미식별출적쌍상장애경다적반유정신병성증상（χ2＝3.99，P ＝0.046）。종합의원중미식별출적경조광증상“목전발작”비솔경고（χ2＝8.15， P ＝0.017）。결론：종합의원화정신전과의원억욱장애문진환자중쌍상장애적루진화오진인소불동。
Objective:To analyze the clinical features and related factors of bipolar disorder in depressive outpatients between a general hospital and a psychiatric hospital. Method:One hundred outpatients with de-pressive episode were enrolled in a general hospital and a psychiatric hospital,50 seperately,according to the in-clusion criteria. And the general questionnaire and mini international neuropsychiatric interview(MINI)were used to identify the bipolar disorder and preliminarily analyze the clinical charactristics. Results:The detected rate of unrecognized bipolar disorder among 41 ~ 50 age in the psychiatric hospital were higher than those in the general hospital(Z = 2. 11,P = 0. 035),while the total detected rate in two hospitals were no significantly dif-ferent(χ2 = 2. 38,P = 0. 123). Moreover,the member of unrecognized bipolar disorder significantly negatively correlated with age(r = - 0. 46,P = 0. 001)and the age of onset(r = - 0. 37,P = 0. 008)in the psychiatric hos-pital. There were significant differences on the age( t = 2. 43,P = 0. 02)and the age of onset( t = 3. 67, P = 0. 01)in the outpatients with bipolar disorder between the two types hospitals. The unrecognized bipolar dis-orders comorbiding psychotic features in the psychiatric hospital were significantly more than that in general hos-pital(χ2 = 3. 99,P = 0. 046). The currently hypomanic episodes in the general hospital were significantly more than that in psychiatric hospital(χ2 = 8. 15,P = 0. 017). Conclusion:There were different factors on the un-recognition or misdiagnosis of bipolar disorder between the general hospital and the psychiatric hospital.