难治性抑郁症危险因素的对比研究

目的：探讨难治性抑郁症的相关危险因素，为临床防治及护理提供依据。方法：将190例难治性抑郁症标准的抑郁症与同期的非难治性抑郁症进行1：1配比病例对照研究，应用条件Logistic回归分析方法处理数据。结果：多因素条件Logistic回归分析表明难治性抑郁症的危险因素是：双相情感障碍（OR：3．689，95％CI：1．816～7．332），神经质（OR：4．461，95％CI：1．791～10．890），伴有精神病性症状（OR：4．362，95％CI：2．184～8．411），情感疾病家族史（OR=0．368，95％CI：0．020～0．917），1年内未及时治疗（OR：0．409，95％CI：0．208～0．830）。结论：具有双相情感障碍、神经质、伴有精神病性症状、情感疾病家族史、1年内未及时治疗与加强护理是难治性抑郁症的重要危险因素。

Study of the risk factors of refractory depression

Objective:To explore the risk factors of refractory depression and to provide the clinician with some indications for prevention and treatment.Methods:A 1:1matched case-controll study was carried out in including 190 cases and the same number of controls.A conditional logistic regression model was used for statistical analysis.Results: Multivariate conditional logistic regression analysis showed that refractory depression was significantly related with five risk factors including bipolar disorder(OR=3.689,95%CI:1.816~7.323),neuroticism(OR=4.461,95%CI:1.792~10.891),with psychotic symptoms(OR=4.363,95%CI:2.185~8.412),family history of mood disorder(OR=0.369,95%CI:0.0121~0.918),inadequate treatment within the first year(OR=0.410,95%CI:0.209~0.831).Conclusions: Bipolar disorder,neuroticism,with psychotic symptoms,family history and inadequate treatment and nursing within first one year were main risk factors for refractory depression.