住院抑郁症患者联合心境稳定剂治疗的影响因素研究

目的对联合心境稳定剂(MS)治疗的住院抑郁症患者的临床特征进行分析,探讨其影响因素,为临床治疗提供参考。方法回顾性分析2013年12月-2016年11月于首都医科大学附属北京安定医院抑郁症治疗中心住院的共472例抑郁症重度发作患者的临床资料,对联合或不联合MS治疗的抑郁症患者人口学资料和疾病特征进行比较。结果联合MS治疗的患者比例为8.3%(39/472)。与未联合MS治疗组相比,联合MS治疗组患者年龄较小(Z=-4.435,P0.01),更多男性(64.1%vs.37.6%,χ~2=10.451,P0.01),更多无配偶(41.0%vs.19.9%,χ~2=9.460,P0.01),更多无业(38.5%vs.21.0%,χ~2=6.253,P0.05),更多18岁前起病(43.6%vs.7.2%,χ~2=51.977,P0.01),更多难治性抑郁(17.9%vs.4.6%,χ~2=11.787,P0.01),较少伴有焦虑特征(23.1%vs.44.7%,χ~2=6.813,P0.01),抗精神病药物使用率更高(76.9%vs.54.5%,χ~2=7.311,P0.01)。多元回归分析显示,患者年轻(OR=0.9,95%CI:0.91~0.98,P0.05),男性(OR=2.4,95%CI:1.1~5.7,P0.05),18岁前起病(OR=0.2,95%CI:0.05~0.4,P0.01),难治性抑郁(OR=4.9,95%CI:1.5~15.9,P0.01),更多使用抗精神病药物(OR=2.4,95%CI:1.1~5.7,P0.05)均是联合MS治疗的影响因素。结论青壮年、起病早、男性、难治性、接受抗精神病药物治疗的抑郁症患者可能更多联合心境稳定剂进行治疗。

Clinical characteristics and influencing factors of mood stabilizer augmentation for the treatment of hospitalized patients with depressive disorder

Objective To explore influencing factors of mood stabilizer (MS) augmentation for the treatment of hospitalized patients with depressive disorder by the analysis of the clinical characteristics, for providing evidences for clinical treatment.Methods A retrospective analysis was performed on clinical data of all 472 patients with depressive disorder who were admitted to Depression Treatment Center in Beijing Anding Hospital between December 2013 and November 2016.The data were concerned the demography and clinical characteristics to compare the differences between MS augmentation group and non-MS group.Results The proportion of MS augmentation was 8.3% (39/472).Compared to non-MS group, the characteristics of MS augmentation group were younger (Z=-4.435, P<0.01), more male (64.1% vs.37.6%, χ2=10.451, P<0.01), more single (41.0% vs.9.9%, χ2=9.460, P<0.01), inoccupation (38.5% vs.21.0%, χ2=6.253, P<0.05), age of onset under 18 years old (43.6% vs.7.2%, χ2=51.977, P<0.01), more treatment resistant depression (17.9% vs.4.6%,χ2=11.787, P<0.01), less anxiety features (23.1% vs.44.7%, χ2=6.813, P<0.01), more antipsychotics use (76.9% vs. 54.5%, χ2=7.311, P<0.01).Logistic regression analyses demonstrate that younger age (OR=0.9, 95%CI: 0.91~0.98, P<0.05), male gender (OR=2.4, 95% CI: 1.1~5.7, P<0.05), age of onset under 18 years old (OR=0.2, 95%CI: 0.05~0.4, P<0.01), treatment resistant depression (OR=4.9, 95%CI: 1.5~15.9, P<0.01), antipsychotics use(OR=2.4, 95%CI: 1.1~5.7, P<0.05) were influencing factors of MS augmentation.Conclusion Clinical psychiatrists tend to choose mood stabilizer augmentation for the treatment of hospitalized depressive patients with the characteristics of younger age, early onset of illness, male, treatment resistant depression and current antipsychotic use.