中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2014年
4期
212-216
,共5页
曹瑞想%马辉%杨华%杨娟%罗厚员%曲海涛%张宁
曹瑞想%馬輝%楊華%楊娟%囉厚員%麯海濤%張寧
조서상%마휘%양화%양연%라후원%곡해도%장저
抑郁症%汉密尔顿抑郁量表%有效性研究
抑鬱癥%漢密爾頓抑鬱量錶%有效性研究
억욱증%한밀이돈억욱량표%유효성연구
Major depressive disorder%Hamilton Depression Scale%Validation studies
目的 探讨界定抑郁症临床治愈的17项HAMD(HAMD17)评分的临界值,并检验其有效性.方法 对251例经治疗症状得到明显改善的抑郁症患者评定HAMD17、大体评定量表、生活质量综合评定问卷,并应用受试者工作特征曲线法分析临界值.结果 抑郁症患者经过急性期治疗,HAMD17≤7分时,92.3％(203/220)的被试者存在至少一种阈下症状,48.6％ (107/220)的患者心理社会功能未恢复正常.HAMD17评分0～3分组患者心理功能、社会功能、躯体功能评分[分别为(60.1±15.4)、(62.0±l1.2)、(60.5±14.3)分],高于4～ 14分组患者[分别为(52.0±12.3)、(54.0±11.0)、(52.7±10.2)分],差异具有统计学意义(t=3.307、4.119、3.626,均P＜0.01).0～3分组心理社会功能恢复正常的比例(74.2％,92/124)高于4～ 14分组患者(12.6％,16/127;x2=97.103,P＜0.01).结论 抑郁症患者经过急性期治疗,HAMD17评分0～3分的患者心理社会功能更好,当HAMD17评分＞3分时,患者可能存在较多的阈下症状,临床上应予以重视.
目的 探討界定抑鬱癥臨床治愈的17項HAMD(HAMD17)評分的臨界值,併檢驗其有效性.方法 對251例經治療癥狀得到明顯改善的抑鬱癥患者評定HAMD17、大體評定量錶、生活質量綜閤評定問捲,併應用受試者工作特徵麯線法分析臨界值.結果 抑鬱癥患者經過急性期治療,HAMD17≤7分時,92.3％(203/220)的被試者存在至少一種閾下癥狀,48.6％ (107/220)的患者心理社會功能未恢複正常.HAMD17評分0～3分組患者心理功能、社會功能、軀體功能評分[分彆為(60.1±15.4)、(62.0±l1.2)、(60.5±14.3)分],高于4～ 14分組患者[分彆為(52.0±12.3)、(54.0±11.0)、(52.7±10.2)分],差異具有統計學意義(t=3.307、4.119、3.626,均P＜0.01).0～3分組心理社會功能恢複正常的比例(74.2％,92/124)高于4～ 14分組患者(12.6％,16/127;x2=97.103,P＜0.01).結論 抑鬱癥患者經過急性期治療,HAMD17評分0～3分的患者心理社會功能更好,噹HAMD17評分＞3分時,患者可能存在較多的閾下癥狀,臨床上應予以重視.
목적 탐토계정억욱증림상치유적17항HAMD(HAMD17)평분적림계치,병검험기유효성.방법 대251례경치료증상득도명현개선적억욱증환자평정HAMD17、대체평정량표、생활질량종합평정문권,병응용수시자공작특정곡선법분석림계치.결과 억욱증환자경과급성기치료,HAMD17≤7분시,92.3％(203/220)적피시자존재지소일충역하증상,48.6％ (107/220)적환자심리사회공능미회복정상.HAMD17평분0～3분조환자심리공능、사회공능、구체공능평분[분별위(60.1±15.4)、(62.0±l1.2)、(60.5±14.3)분],고우4～ 14분조환자[분별위(52.0±12.3)、(54.0±11.0)、(52.7±10.2)분],차이구유통계학의의(t=3.307、4.119、3.626,균P＜0.01).0～3분조심리사회공능회복정상적비례(74.2％,92/124)고우4～ 14분조환자(12.6％,16/127;x2=97.103,P＜0.01).결론 억욱증환자경과급성기치료,HAMD17평분0～3분적환자심리사회공능경호,당HAMD17평분＞3분시,환자가능존재교다적역하증상,림상상응여이중시.
Objective To explore the optimal cutoff point defining remission on 17-item Hamilton Depression Scale (HAMD17) for major depressive disorder (MDD),and examine the validity of this cutoff point.Method We interviewed 251 MDD responders with the HAMD17,Global Assessment of Functioning,Generic Quality of Life Inventory.Results After acute phase treatment for MDD,even the HAMD17 scored 7 or less,92.3％ (203/220) of remitters had at least one subthreshold depressive symptoms,48.6％ (107/220) of them also experienced functioning impairment,when psychosocial functioning taken into account,a cutoff of ≤ 3 might be the operational criterion of MDD remission.Compared to MDD patients scoring 4-14 on HAMD17,patients scoring 0-3 had significantly better psychological functioning,social functioning and physical functioning (separately 60.1 ± 15.4 vs.52.0 ± 12.3,62.0 ± 11.2 vs.54.0 ± 11.0,60.5±14.3vs.52.7±10.2; t=3.307,4.119,3.626,all P＜0.01).Compared to4-14 score group,the rate of ones with psychosocial functioning being normal in 0-3 score group was higher (74.2％ vs.12.6％ ; x2 =97.10,P ＜ 0.01).Conclusion The results indicate that patients with MDD whose score of ≤3 on HAMD17 after the acute phase treatment may have better psychosocial functioning than those whose score of ＞ 3,suggesting this criterion be valid.
