难治性抑郁症的临床特征分析

目的探讨难治性抑郁症患者的临床特征及相关影响因素。方法采用自编一般情况量表、汉密顿抑郁量表、汉密顿焦虑量表、社会支持量表、及生活事件量表，对入组的难治性抑郁症和非难治性抑郁症进行调查和评定，并做相关统计分析。结果难治性抑郁症组在伴有其他慢性躯体疾病和慢性起病者的频率显著高于非难治性抑郁症组。两组在发作次数、住院次数、起病形式、绝望感、躯体焦虑方面有显著差异（P〈0．05）。多元逐步回归显示影响难治性抑郁症因素依次为：伴有其他慢性躯体疾病、首次发病年龄、慢性起病形式及躯体焦虑因子。结论发作次数频繁，病中绝望感重、躯体焦虑明显可能是难治性抑郁症的有效预测因子，临床上仅凭患者的症状严重程度不足以区分两组患者。抑郁症伴有其它慢性躯体疾病、首次发作年龄偏小、起病形式缓慢且躯体焦虑症状严重者，可能是导致抑郁症难治性的潜在危险因素。

Clinical features of treatment-resistant depression

Objective To explore the clinical features and related factors of patients with treatment-resistant depression（TRD）. Methods The two groups were interviewed with a case history questionnaire, Hamilton Depression Rating Scale（HAMI）24）, Hamilton Aaxiety Scale （HAMA） ,Social Support Rating Scale （SSRS） and Life Events Scale （LES）. Results Compared with NTRD,the frequent of companied with chronic physial dis- eases and chronic onset in TRD were higher. Times of episode and hospitalization,type of onset,and feeling of desperation and body anxiety had significantly differences between two groups. Logistic regression analysis re- vealed that the factors related to treatment-resistant depression included other chronic physical disease,age of first onset,chronic onset and body anxious factor of the HAMA. Conclusion The patients of two groups could not be distinguished only from the clinical symptoms. Other chronic physical diseases,age of first onset chronic onset,and body anxious factors are likely to be the potential risk factors of treatment-resistant depression.