难治性抑郁症患者的危险因素分析

摘要

Objective: To explore the risk factors of refractory depression and to provide the clinician with some indications for prevention and trealment. Method: A 1-1 matched case-control study was carried out in including 100 cases with refractoy depression patient and the same number of controls. The two groups were interviewed with a case history questionnaire, personality diagnosis questionnaire-4 (PDQ-4), eysenck personality questionnaire(EPQ) .social support rating scale and life events scale. A conditional Logistic regression model was used for statistical analysis. Results: Multivariate conditional Logistic regression analysis showed that refractory depression was significantly related with seven risk factors including stressful life events(OR =3. 725, 95%CI:1.684 ~7.282) .deficiency social support (OR =4. 257,95%CI: 1.790 -9.887) ,neuroticism(OR = 4. 124,95%CI::l.776 -8.231) .with personality disorder(OR=4. 875,95%CI:2.432 - 10.245) .with deper-Bonalization (OR =0. 384.95%CI:0.156 -0.898) .with obsessive symptoms(OR = 0.401,95%CI: 0.219-0.976) o and inadequate treatment within the first year( OR =0. 406,95%CI:0.206 ~0.844). Conclusion: Stressful life events,deficiency social support,neuroticism,with personality disorder,with depersonalization,with obsessive symptoms,and inadequate treatment within first one year were main risk factors for refractory depression.%目的:探讨难治性抑郁症的相关危险因素. 方法:将100例符合难治性抑郁症诊断标准的抑郁症患者与同期的非难治性抑郁症患者进行1:1配比病例对照研究,采用自编一般情况调查表、人格诊断问卷( PDQ-4)、艾森克人格问卷(EPQ)、社会支持量表以及生活事件量表对入组的抑郁症患者进行调查和评定,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:应激性生活事件( OR =3.725,95％CI:1.684-7.282),社会支持差(OR=4.257,95％ CI:1.790～9.887),神经质(OR =4.124,95％ CI:1.776～8.231),伴人格障碍(OR =4.875,95％CI:2.432～10.245),伴人格解体(OR =0.384,95％ CI:0.156-0.898),伴强迫症状(OR =0.401,95％ CI:O.219～0.976),1年内未及时治疗(OR =0.406,95％ CI:0.206～0.844). 结论:具有应激性生活事件、社会支持差、伴人格障碍、神经质(EPQ-N量表分)、伴人格解体症状、伴强迫症状、1年内未及时治疗是难治性抑郁症的主要危险因素.