摘要
目的对当前有和无自杀观念的难治性抑郁症患者的临床特征进行对照分析。方法按最近1周有无自杀观念将327例难治性抑郁症患者分为自杀观念组(n=59)和无自杀观念组(n=268),比较其人口学和临床特征,并对自杀观念的危险因素进行Logistic回归分析。结果自杀观念组的目前年龄、首次发病年龄、17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、临床大体印象量表(CGI)和HAMD-24的绝望感条目的评分均明显高于无自杀观念组(P<0.05),自杀观念组的精神病性症状(OR=4.03,P<0.05)、不典型症状(OR=7.53,P<0.01)和躯体疾病共病(OR=11.19,P<0.01)明显多于无自杀观念组。回归分析结果显示,HAMD-17总分(OR=1.19,P<0.01)、绝望感(OR=2.13,P<0.01)、不典型症状(OR=1.44,P<0.05)和躯体疾病共病(OR=2.84,P<0.05)与自杀观念相关。结论有自杀观念的难治性抑郁症具有一定的人口学和临床特征,应对其进行综合评估和干预。
Objective To compare clinical characteristics between patients with treatment-resistant depression （TRD） with suicidal ideation and those without current suicidal ideation.Methods Three hundred and twenty-seven outpatients or inpatients were divided into 2 groups; TRD with （n=59） and without （n=268） current suicidal ideation within 1 week.Sociodemographic and clinical data were compared between two groups.Binary logistic regression models were used to assess risk factors of co-current suicidal ideation.Results Age,age at first on-set,and scores of 17 items Hamilton rating scale for depression（HAMD-17）,Hamilton anxiety scale（HAMA）,clinical global impression（CGI） and hopelessness （assessed by hopelessness item of HAMD-24） of TRD with suicidal ideation were significantly higher than those of TRD without suicidal ideation （P0.05）.Significant differences among constituent ratio of psychotic symptoms （OR=4.03,P0.05）,atypical symptoms （OR=7.53,P0.01）,and medical comorbidity （OR=11.19,P0.01） of TRD with suicidal ideation were higher than those of TRD without suicidal ideation.Binary logistic regression analysis indicated that HAMD-17 score（OR=1.19,P0.01） and hopelessness score（OR=2.13,P0.01）,atypical symptoms （OR=1.44,P0.05） and medical comorbidity （OR=2.84,P0.05） were significantly associated with suicidal ideation.Conclusions Specific demographic and clinical features are associated with suicidal ideation among patients with TRD.Integrated clinical assessment and intervention should be taken for TRD patients with suicidal ideation.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2010年第10期598-602,共5页
Chinese Journal of Nervous and Mental Diseases
基金
"十五"国家科技攻关计划(编号:2004BA720A21-02)
"863"计划(编号:2006AA02Z430)
上海市科委"登山行动计划"(编号:064119533)
关键词
难治性抑郁症
自杀观念
临床特征
对照研究
Treatment-resistant depression （TRD） Suicidal ideation Clinical characteristics Case-control study
