门诊首发抑郁症临床现象学分析

目的　了解首发抑郁症临床特征。方法　采用自制一般情况调查表、自制抑郁及焦虑症状调查有对符合ICD 10抑郁发作诊断标准的 14 4例门诊首发抑郁症患者进行研究。采用汉密顿抑郁量表 (HAMD2 4)、汉密顿焦虑量表 (HAMA)评定疾病的严重程度 ;采用生活满意度量表 (LSR)、社会功能缺陷筛选量表 (SDSS)、生活事件量表 (LES)评定患者的生活质量和社会功能。结果　 14 4例首发抑郁症患者心境低落出现频率高达 10 0 % ,工作兴趣减少为 95 8% ,思维迟缓为 84 7% -能力减退感为 97 2 % ,早醒为 92 4 % ,睡眠不深为 90 3% ,性欲减退和 /或月经紊乱为 82 6 % ,同时伴有昼重夜轻 ,躯体化症状。男性患者的疑病症状出现频率显著高于女性 (P <0 0 5 ) ;男性患者的性欲减退、绝望感症状出现率高于女性 ;女性患者在自杀意念、精神性焦虑、躯体性焦虑、全身疲乏、晨夜夕轻症状出现频率多于男性 ,但无统计差异。 4 0岁以上患者组比 4 0岁以下组更易表现为睡眠不深、早醒、躯体性焦虑 (P <0 0 5 )。 6 1 1%的患者伴有一定程度的焦虑症状 ;6 0 %的患者伴有躯体化症状。重度抑郁的躯体化症状表现频率显著高于中度患者 (P <0 0 5或P <0 0 1) ,两者社会功能缺陷程度有显著性差异 (P <0 0 1)。结论　首发抑郁症临床以心

Analysis of the clinical features of first-episode major depression

Objective: To study clinical features of the first-episode major depressed outpatients. Methods: 144 cases of outpatients with the first-episode major depression diagnosed according to ICD-10 were enrolled and were assessed with self-made evaluation form, HAMD 24 rating scale, HAMA rating scale, LSR, SDSS and LES. Results: Among the sample, the appearance rate of depressed mood is 100 percent, helplessness is 97.2 percent, work and interests reduce is 95.8 percent, insomnia-late is 92.4 percent, insomnia- middle is 90.3 percent, retardation is 84.7 percent, genital symptoms is 82.6 percent, also companied with diurnal variation, somatic symptoms. Males show statistically more hypochondriasis symptom than females do (P< 0.05). Males display more genital symptoms, hopelessness. While female display, more rates than male with the symptoms of attempted suicide, psychic anxiety, somatic anxiety, general somatic symptoms, diurnal variation. Outpatients above forties display statistically higher appearance rate of insomnia-middle, insomnia-late, psychic anxiety than patients below forties (P<0.05). 61.1 percent of the sample comorbid with anxious symptom. The severe depressed patients display significantly higher rates on somatic symptoms (P<0.05 or P<0.01), and also have more marked disability on social function (P<0.01). Conclusion: First-episode major depression mainly display depressed mood, work and interests reduce, retardation, helplessness, insomnia-late, comordid with anxiety and somatic symptoms. The severe depression exists obvious disability on social function.