抑郁症患者及其家属的家庭功能关系研究

目的探讨抑郁症患者及其家属家庭功能之间的关系，以及抑郁程度对患者及其家属的家庭功能的影响。方法采用家庭功能量表（Family Assessment Device，FAD）中文版、汉密尔顿抑郁量表17项版本（Hamilton Depression Scale-17，HAMD-17）比较患者及其家属家庭功能之间，以及抑郁症严重程度与家庭功能的关系。按照HAMD-17总分将患者及其家属分组后，探讨抑郁症严重程度对家庭功能的影响。结果患者及其家属的行为控制差异有统计学意义（t=-3．299，P〈0．05）。HAMD-17总分与患者的问题解决（r=0．391，P〈0．01）、沟通（r=0．376，P〈0．01）、家庭角色（r=0．437，P〈0．01）、行为控制（r=0．427，P〈0．01）、情感卷入（r=0．299，P〈0．05）、总体功能（r=0．294，P〈0．05）显著相关；与家属的问题解决（r=0．362，P〈0．01）、沟通（r=0．303，P〈0．05）显著相关。急性发作组患者及家属的家庭角色（t=2．984，P〈0．01）、总体功能（t=2．967，P〈0．01）、问题解决（t=2．224，P〈0．05）差异有统计学意义。完全缓解组患者及家属的行为控制（t=-4．980，P〈0．01）差异有统计学意义。患者的行为控制（H=11．353，P〈0．01）、问题解决（H=7．527，P〈0．05）、家庭角色（H=7．480，P〈0．05）的组间差异有统计学意义。结论抑郁症患者及其家属的家庭功能差异不明显，但抑郁症状会扩大两者的差异性；症状的严重程度对患者家庭功能的影响更加明显；抑郁症状对家庭功能的影响主要表现在问题解决和沟通方面。

Family functioning of patients with depression and their family members

Objective To investigate family functioning of patients with depression and its relation to the family functioning of their family members. Methods Hamilton Depression Rating Scale-17 （HAMD-17） and Family Assessment Device （FAD）were used to compare the family functioning of patients with that of family members. Patients and family members were grouped according to HAMD-17 total scores, the effect of depression severity on family functioning was studied. Results There was significant difference in behavior control between patients and family members （ t = - 3. 299, P 〈 0.05 ）. The total scores of HAMD-17 were closely correlated with problem solving （ r = 0. 391, P 〈 0.01 ）, communication （ r =0.376, P 〈0.01 ）, family role （ r =0.437, P 〈0.01 ）, behavior control （ r =0.427, P 〈 0.01 ）, affective involvement （ r = 0.299, P 〈 0.05 ） and general functioning （ r = 0.294, P 〈 0.05 ） of patients; and also with problem solving （ r = 0. 362, P 〈 0.01 ） and communication （ r = 0.303, P 〈0.05） of family members. In acute episode group there were significant differences in family role （ t = 2.984, P 〈 0.01 ）, general functioning （ t = 2. 967, P 〈 0.01 ） and problem solving （ t = 2.224, P 〈 0.05 ） between patients and family members. In complete remission group there was significant difference in behavior control（ t = - 4.980, P 〈 0.01 ） between patients and family members. There were significant differences in behavior control （H = 11. 353, P 〈 0.01 ）, problem solving （ H = 7. 527, P 〈 0.05 ） and family role （H = 7. 480, P 〈 0.05 ） of patients between groups. Conclusion The severity of depression has marked effect on family functioning of patients. The problem solving and communication are the main aspects of family functioning affected by depressive symptoms.