目的：探讨伴精神病性症状单相与双相抑郁障碍的临床特征，为临床诊断提供依据。方法将56例伴精神病性症状单相抑郁障碍患者设为单相组，53例伴精神病性症状双相抑郁障碍患者设为双相组。两组均予以艾司西酞普兰联合喹硫平治疗，双相组辅以碳酸锂治疗。采用自制一般资料调查表、汉密顿抑郁量表、阳性与阴性症状量表进行测评分析。结果双相组病程显著长于单相组（ P＜0．05或0．01），阳性精神病家族史及病前不良个性检出率显著高于单相组（ P＜0．05或0．01）；治疗前妄想、被动体验、情感低落检出率显著低于单相组（ P＜0．05或0．01），自杀观念和自杀行为检出率显著高于单相组（ P＜0．05或0．01）。结论伴精神病性症状的双相抑郁障碍与单相抑郁障碍相比，具有病程较长、家族史阳性率较高、病前不良个性较多、伴精神病性症状时间较长等特点，自杀风险较高。%Objective To explore the clinical features of unipolar and bipolar disorder patients with psy-chotic symptoms (PS) in order to provide basis for clinical diagnosis .Methods Fifty-six unipolar disorder patients with PS were assigned to unipolar group and 53 bipolar ones to bipolar group .Both groups were treated with escitalopram and quetiapine ,bipolar group was plus lithium carbonate .Assessments were car-ried out with self-made general data questionnaire ,Hamilton Depression Scale (HAMD) and Positive and Negative Symptom Scale (PANSS) .Results Course was significantly longer (P<0 .05 or 0 .01) and de-tection rate of positive psychosis family history and premorbid unhealthy personality higher ( P<0 .05 or 0 .01) in bipolar than unipolar group ;detection rate of pretreatment delusion ,passive experience ,hypot-hymia was significantly lower (P<0 .05 or 0 .01) and that of suicidal ideation and behavior higher (P<0 .05 or 0 .01) in bipolar than unipolar group .Conclusion Bipolar disorder patients with PS have such characteristics as longer course ,higher positive rate of family history ,more premorbid unhealthy personal-ities ,longer psychotic symptoms and higher suicide risk compared with unipolar ones .
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