隐匿型抑郁症的诊断鉴别和误诊分析

目的　本文报告 2 8例 3种隐匿型抑郁症的临床特征和误诊分析。方法　使用改良的国际通用汉米尔顿抑郁量表 (HAMD)进行患者异常的情绪和心理分析 ,使用视觉模拟评分 (VAS)评价患者的慢性疼痛状态。结果　通过使用视觉模拟评分法测定患者的评分为平均 6.2分 ,但是经过仔细的体检难以发现与之相称的临床症状和体征 ;使用改良的汉米尔顿抑郁量表测评本组患者的抑郁评分均值为 1 7.8分 ,临床上属于中等程度的抑郁程度。结论　对于第一主诉为慢性疼痛的患者除了要仔细询问病史、全面体检、正确的 VAS评分评估 ,排除相关的痛症外 ,还应该使用汉米尔顿抑郁量表对患者进行情绪和心理分析 ,同时观察患者对不同的镇痛药物、方法的反应性 ,以减少隐匿型抑郁症的误诊率

Clinical Features and Misdiagnosis of Masked Depression

Objective Clinical features and analyses of 28 misdiagnoses of masked depression were discussed,in order to reduce the misdiagnosis of this disease.Methods The modified Hamilton rating scale for depression(HAMD) was used to analyse patient's mood and psychological disorders,and the Visual analogue scales(VAS) was adopted to assess patients' pain condition.Results Average score of modified Hamilton rating scale for depression in this group was 17.8,meaning middle level of depression,and that of visual analogue scales was 6.2,but there was no evident clinical symptoms and signs matching the scale.Conclusion Careful physical and psychological examination and correct VAS should be taken in patients who complained chronic pain as their first symptom, in addition,HAMD should be done to analyse patients'mood and psychological disorders,and at the same time responses to pain relief pills and some special nerve block treatment were also performed to reduce misdiagnosis of masked depression as much as possible.