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抑郁症共病焦虑障碍一年随访研究 被引量:9

One year outcome of patients with comorbid depression and anxiety disorders
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摘要 目的观察抑郁症共病焦虑障碍患者1年(12个月)随访结果及复发相关因素。方法本研究为前瞻性、多中心、队列随访研究;采用17项汉密尔顿抑郁量表(HAMD17)和汉密尔顿焦虑量表(HAMA)对594例抑郁症患者进行3、6、12个月随访评估,比较抑郁症共病焦虑障碍(共病组,344例)与非共病焦虑障碍(非共病组,250例)的临床痊愈率、复发率、自杀念头、服药依从性、联合治疗的差异;采用logistic逐步回归分析复发相关因素。结果3、6、12个月3个时点随访到的患者分别为482、441、301例。3个月时,共病组临床痊愈率(53.7%,153/285)低于非共病组(68.0%,134/197),差异有统计学意义(P〈0.01)。3个月和6个月时,共病组HAMD总分[(8.80±6.49)、(6.86±7.07)分]和HAMA总分[(6.35±4.64)、(4.88±4.63)分]均高于非共病组[HAMD:(7.20±5.97)、(5.33±5.86)分,HAMA:(4.77±4.26)、(3.38±3.69)分],12个月时共病组HAMA总分[(3.98±4.01)分]高于非共病组[(2.97±3.95)分],差异均有统计学意义(P〈0.05或P〈0.01)。3、6、12个月3个时点共病组与非共病组的复燃率分别为6.7%(19/285)VS5.6%(11/197),13.3%(36/270)vs8.2%(14/171),14.9%(30/202)vs9.1%(9/99),2组比较差异无统计学意义(P均〉0.05);但生存分析显示,2组1年复发率差异有统计学意义(χ^2=4.487,P〈0.05)。2组自杀念头、转躁率、服药依从性和社会功能差异均无统计学意义(P均〉0.05)。共病组和非共病组分别有50.5%和43.4%的患者在1年随访时仍合用苯二氮革类药。Logistic多元回归分析显示,6个月时自杀念头[OR=32.258,95%可信区间(CI)7.092~142.857,P〈0.01]和服药依从性(OR=0.564,95%CI0.363~0.877,P〈0.05)与复发有� Objective To observe one year outcome of patients with depression eomorbidity with anxiety disorders and predictor factors to recurrence. Method Totally 594 patients from 17 hospitals, met with the diagnosis criteria of DSM-IV for depression, were prospectively evaluated using the 17-item Hamilton Rating Scale for Depression ( HAND17 ) and Hamilton Rating Scale for Anxiety (HAMA) at the end of 3,6 and 12 months since they were enrolled the study. The conditions of remission, relapse, suicide idea, compliance with medicine and combined therapy were compared between depression eomorbidity with (344cases) or without(250 cases) anxiety disorder. Logistic regression analysis was performed to investigate the recurrent predictors of depression. Results There were 482,441 and 301 patients at the three following points separately. The rate of remission in 3 month was significantly lower in comorbidity group (CG) than that in without comorbidity group (WCG) (53.7% vs. 68.0%, P = 0. 002). The scores of HAMD [ (8.80 ± 6. 49 ), ( 6. 86 ± 7.07 ) ] and HAMA [ (6. 35 ± 4. 64 ), ( 4. 88 ±4. 63 ) ] both were significantly higher in CG than those [ HAMD : (7.20 ±5.97 ), ( 5.33 ±5.86), HAMA : (4. 77 ± 4. 26 ), ( 3.38 ±3.69 ) ] in WCG. And only HAMA score (3.98 ±4. 01 ) in CG was marked higher than that ( 2. 97 ± 3.95 ) in WCG ( P 〈 0. 05 or P 〈 0. 01 ). In three different following points, the rates of relapse / recurrence were 6. 7 % vs. 5.6% , 13.3 % vs. 8.2% ,and 14. 9% vs. 9. 1% separately,no significant differences between two groups ( P 〉 0. 05 ). But the Kaplan-Meier survival analysis showed the higher recurrent rate in CG (χ2 = 4. 487 ,P 〈 0. 05 ). The rate of suicide idea converting mania, compliance with medicine and social function were no significant differences within two groups (P 〉0. 05). About half of patients (50. 5% in CG and 43.4% in WCG) were still using benzodiazepines after one year. Logistic regress
作者 施慎逊 张明园 陆峥 吴文源 周天骍 张海音 刘义兰 赵靖平 孙学礼 李鸣 张宁 刘少文 陶明 李惠春 杨蕴萍 魏镜 季建林 赵宝龙 陈圣祺 瞿正万 SHI Shen-xun , ZHANG Ming-yuan,LU Zheng, WU Wen-yuan, ZHOU Tian-xin, ZHANG Hai-yin, LIU Yi-lan, ZHAO Jing- ping, SUN Xue-li, LIMing, ZHANG Ning, LIU Shao-wen, TAO Ming, LI Hui-chun, YANG Yun-ping, WEI Jing, JI Jian-lin, ZHAO Bao-long, CHEN Sheng-qi, ZHAI Zheng-wan Psychiatry Department of Huashan Hospital, Fudan University, Shanghai 200032, China
出处 《中华精神科杂志》 CAS CSCD 北大核心 2013年第4期212-216,共5页 Chinese Journal of Psychiatry
关键词 抑郁症 焦虑 共病现象 复发 随访研究 Depressive disorder Anxiety Comorbidity Recurrence Follow-up studies
作者简介 通信作者:施慎逊,Email:shishenxun@163.com; 通信作者:张明园,Email:myzhang@gmail.com
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