高血压患者抑郁障碍的诊治

目的　调查 182例高血压患者的抑郁障碍情况 ,为高血压的心理干预提供依据。方法　以DSM Ⅳ为标准诊断抑郁障碍 ,Zung抑郁自评量表评价其严重程度。将伴抑郁障碍的高血压分为两组 :对照组 (常规内科治疗 )及治疗组 (常规内科治疗 +多虑平 ) ,随访 12周 ,以高血压症状计分及Zung积分减少 5 0 %或以上为治疗有效。 结果　 182例高血压中3 4例诊断为抑郁障碍 ,其发生率为 18.68% ;治疗组的有效数为 12 / 16例 ,其高血压症状分和Zung积分明显下降 ,与对照组有显著性差异 (P <0 .0 0 1) ;治疗组的血压水平明显低于对照组 ,有显著性差异 (P <0 .0 5 )。结论　高血压伴随的抑郁障碍发生率高 ,抗抑郁治疗能有效地改善抑郁和高血压症状 ,同时降低高血压患者的血压水平

Diagnosis and Treatment of Depression in Patients with Hypertension

:Objective　To investigate the prevalence of depression in the patients with hypertension and to offer the basis for the psychological intervention to hypertension.Method　Clinical trial was conducted to compare the efficacy and the adverse reactions between the treatment group(routine therapy+doxepine) and the control group(routine therapy).Depression was diagnosed according to DSM-Ⅳ criteria and the severity of depressive symptoms was evaluated with the Zung Depression Scale.The patients were followed up for 12 weeks.Results　The prevalence of depression was 18.68%(34/182) in hypertension;the effective number in the treatment group was 12/16;the mean Zung scores and hypertension scores descended significantly after the treatment in the treatment group(P<0.001 vs control group).The level of blood pressure in the treatment group was significantly lower than that in control group(P<0.05).Conclusions　The prevalence of depression is high in patients with hypertension.Anti-depression therapy can improve the depressive and hypertensive symptoms effectively,and reduce the level of blood pressure in hypertension simultaneously.