目的 比较不同性质医疗机构精神科门诊抑郁障碍患者的临床特征和治疗情况.方法 使用一般情况调查表和简明国际神经精神访谈对综合医院和精神专科医院精神科门诊100例抑郁障碍患者进行调查,对不同性质医疗机构患者的临床特征和治疗情况进行比较分析.结果 综合医院精神科门诊抑郁障碍患者的年龄和首次抑郁发作的年龄都大于精神专科医院患者(P ＜ 0.01).综合医院患者抑郁发作时有不典型症状的比例高于精神专科医院(P ＜ 0.05),而精神专科医院患者中有焦虑症状(P ＜ 0.05)、复发性抑郁(P ＜ 0.01)和有精神病性症状(P ＜ 0.05)的比例均高于综合医院,自杀风险的等级也高于综合医院(P ＜ 0.05).综合医院精神科门诊抑郁障碍患者使用苯二氮类药物的比例较高(P ＜ 0.05),而精神专科医院心境稳定剂的使用比例较高(P ＜ 0.05).两类医院中抗精神病药物的使用和是否有精神病性症状的内部一致性均不高(Kappa ＜ 0.4).结论 综合医院的抑郁障碍患者的临床表现更多不典型的特征,抑郁障碍的药物治疗情况也与专科医院不同,值得临床注意和深入分析.%Objective To analyze the clinical features and treatment models of outpatients with major depressive disorder from general hospital and psychiatric hospital. Methods One hundred outpatients with depressive episode (general hospital and psychiatric hospital were 50 respectively ) were enrolled according to the inclusion criteria. General survey and mini intemational neuropsychiatric interview (MINI) were used to assess the mood spectrum and other clinical characteristics. and the pharmacological treatment. Results The patients with major depressive disorder from general hospital had older age and later onset compared with those from psychiatric hospital (ρ＜ 0.01). More patients had atypical symptoms in general hospital than psychiatric hospital (ρ＜0.05) , whereas more patients had anxiety symptoms (ρ＜0.05), recurrent depression (ρ＜0.01), psychotic features (ρ＜0.05) and higher suicide risks (ρ＜0.05) in psychiatric hospital than in general hospital. The utilization of mood stahilizers was higher in psychiatric hospital (ρ＜0.05) whereas the utilization of benzodiazepines was higher in general hospital (ρ＜0.05). The consistencies of psychotic symptoms and the utilization of' antipsychotic drugs within the two groups were lower (Kappa ＜ 0.4).Conclusion In general hospital. the outpatients with major depressive disorder had more atypical symptoms and the treatment modalities were diff'erent from the psychiatric hospital. which are worthy of attention and in-depth analysis in clinical practice.
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