中文版心境障碍问卷在心境障碍患者中的应用

摘要

Objective To evaluate the feasibility of Chinese version of Mood Disorder Questionnaire ( MDQ-C) in screening patients with mood disorder, and analyse the clinical characteristics of patients with potential bipolar disorder in those with depression disorder. Methods Three hundred and eight patients with mood disorder were evaluated by MDQ-C, including 134 patients with bipolar disorder( bipolar disorder group) and 174 patients with depression disorder (depression disorder group) . The clinical characteristics of patients with MDQ-C score^5 and those with MDQ-C score <5 in depression disorder group were compared and analysed. Results MDQ score in depression disorder group (3. 90 ± 2. 92) was significantly lower than that in bipolar disorder group (6.48 ±3.76) (t =6.574, P =0.000). The percent of patients with MDQ-C score >5 in depression disorder group(34. 5%, 60/174) was significantly lower than that in bipolar disorder group (64.9%, 87/134) (x2 =28.121, P= 0.000). Logistic regression analysis revealed that the majority of patients with depression disorder and MDQ-C score >5 were males (odds ratio =0.342, P =0.004) and younger ones age <25 years (odds ratio =0.952, P = 0.001), and were characterized by appetite increase at first episode (odds ratio =5.007, P =0.029). Conclusion A substantial proportion of patients with depression disorder may have unrecognized bipolar disorder, and MDQ-C may serve as a screening tool to increase the recognition of bipolar disorder. Patients with depression disorder and characteristics of male gender, age < 25 years and appetite increase at first episode may potentially be those with bipolar disorder.%目的 探讨中文版心境障碍问卷( MDQ-C)筛查双相障碍的可行性,对抑郁障碍患者中有双相障碍可能的患者进行临床特征分析.方法 采用MDQ-C对308例心境障碍患者进行测评,包括双相障碍134例(双相障碍组)和抑郁障碍174例(抑郁障碍组).对抑郁障碍组中MDQ得分≥5和MDQ得分＜5的患者的临床特征进行比较分析.结果 抑郁障碍组患者MDQ得分(3.90±2.92)明显低于双相障碍组(6.48±3.76),差异有统计学意义(t=6.574,P=0.000)；抑郁障碍组MDQ得分≥5的患者比例(34.5％,60/174)也明显低于双相障碍组(64.9％,87/134),差异有统计学意义(X2=28.121,P=0.000).Logistic回归分析结果显示:MDQ得分≥5的抑郁障碍患者多为男性(优势比OR =0.342,P=0.004)和年龄＜25岁(OR=0.952,P=0.001)患者,且首次发病存在食欲增强特征(OR =5.007,P=0.029).结论 抑郁障碍患者中未被识别的双相障碍比例较高,MDQ-C可作为筛查工具提高双相障碍的识别率.男性、年龄＜25岁、首次发病存在食欲增强不典型特征的抑郁发作患者有潜在双相障碍的可能.