【摘要】 目的　了解不同区域精神科医生对情感性精神障碍不同亚型的治疗情况及疗效不佳时的进一步处理方法。方法　采用随机分层法抽取保定、上海两市不同职称的精神科医生各 60名进行问卷调查。问卷内容包括医生对 6个不同亚型的情感性精神障碍病例的治疗及医生的一般情况。结果　 ( 1)在抑郁发作时 ,选用频度较高的药物为氟西汀、阿米替林。上海医生多选用氟西汀 ,而保定医生多选用阿米替林。在双相轻中度抑郁发作时 ,有 93 3 %的医生合用碳酸锂。在重度抑郁及其伴精神病性症状时电休克是首选治疗 ,两种亚型首选该治疗的医生分别占 2 9 2 %、2 0 9%。 ( 2 )双相躁狂发作及快速循环发作选用频度较高的药物是碳酸锂 ,分别为 89 2 %、 5 7 5 %。 ( 3 )首选治疗疗效不佳时 ,轻中度抑郁发作多改用另一种抗抑郁药 ,而重度抑郁发作多选用电休克治疗。结论　不同区域经济水平不同 ,精神科医生在情感障碍不同亚型的治疗上也不同更多还原

【Abstract】 Objective To investigate the treatment trend among psychiatrists in different areas for affective disorders and the further management for the poor respondents.Methods A questionnaire survey was given to 60 psychiatrists from Baoding and 60 ones from Shanghai who were stratified randomized selected.The questionnaire consists of general information of the psychiatrists,six model cases with various subtypes of affective disorders and questions related to each case.Results (1)Fluoxetine and amitriptyline were the most common prescription chosen for major depressions.Fluoxetine was significantly more used by psychiatrists in Shanghai than in Baoding,but amitriptyline was the opposite.93.3% of the psychiatrists combined lithium carbonate with antidepressants for bipolar depressive episode.Electroconvulsive therapy was the first choice for severe depressions among 29.2% psychiatrists and for ones with psychotic symptoms among 20.9% psychiatrists.(2)Lithium carbonate was more frequently used for bipolar manic episode(89.2%)and rapid cycling episode(57.5%).(3)The first choice for no response to the first treatment was changed to another antidepressants for mild and moderate depressions and electroconvulsive therapy for severe depression.Conclusion For the treatment of various subtypes of affective disorders,psychiatrists from different economic society have significant differences.更多还原