【摘要】 目的了解双重抑郁症的患病率、临床特征及社会生活功能状况。方法采用随机抽样方法,以美国精神障碍诊断与统计手册-第四版修订版(DSM-Ⅳ-TR)为诊断标准,以DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查病人版(SCID-I/P)为诊断工具,对河北省完成流行病学调查的20716名18岁以上人群中双重抑郁症的患病率、共病、社会功能等临床特征进行分析。采用功能大体评定量表(global assessment of function,GAF)和匹茨堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)中国修订版分别评定患者的功能状况和睡眠质量。结果 20716名被调查者中现患心境恶劣障碍411例,其中56例(13.6%)叠加了重性抑郁发作,符合双重抑郁症的诊断标准。双重抑郁症的时点患病率为0.27%(56/20716),按精神障碍高、中、低危险组SCID诊断的比例校正后的时点患病率为0.47%(95%CI:0.38%～0.56%)。单一的心境恶劣组和双重抑郁症组均有较高的其他精神障碍的共病率(30.99%和46.43%),后者的共病率更高(P<0.05),但两组均以共病未特定的焦虑障碍、广泛性焦虑障碍、特殊恐怖症、创伤后应激障碍、酒依赖/酒滥用等常见。双重抑郁症组GAF评分明显低于单一心境恶劣组(P<0.01),PSQI的总分及入睡时间、睡眠障碍、日间功能因子的评分明显高于心境恶劣组(P<0.05),但两组在性别、文化程度、居住方式、城乡、婚姻状况方面无明显差异(P>0.05)。结论心境恶劣障碍中双重抑郁症的比例不低,而双重抑郁症共病其他精神障碍和社会功能的损害更明显,应引起临床重视。更多还原

【Abstract】 Objective To investigate the prevalence,clinical features and function status of the double depression.Methods An analysis of the prevalence,comorbidity,social function and some other clinical features of double depression was implemented in a large population involving 20716 subjects aged ≥18 by Hebei epidemiology survey using the random sampling method.The American psychiatric association diagnostic and statistical manual of mental disorder the fourth edition(DSM-Ⅳ) and structured clinical interview for DSM-Ⅳ-TR Axis I disorders-patient edition (SCID-I/P) were as diagnostic criteria and diagnostic tools,respectively.Function status and sleep quality were assessed by global assessment functions (GAF) and Pittsburgh morpheus quality index (PSQI) Chinese edition.Results In the sample of 20716,there were 411 patients with dysthymic disorder,13.6%(56/411) of them had major depressive episodes which met the DSM-Ⅳ double depression diagnostic criteria.The point prevalence of double depression was 0.27%(56/20716).The point prevalence was 0.47%(95% CI:0.38%～0.56%)after adjusted by the different diagnosis rate using SCID in the three groups with high,morderate and mild risk for mental disorder.Both single dysthymic disorder group and double depression group had a fairly high other psychiatric disorders of comorbidity rate (30.99% vs 46.43%)and the comorbidity rate of the latter was significantly higher (P<0.05).The comorbidity of dysthymic disorder or double depression and anxiety disorder not otherwise specified,generalized anxiety disorder,specific phobia,posttraumatic stress disorder,alcohol-related disorder were very common in the two groups.Compared with single dysthymic disorder group,double depression group had lower scores of global assessment of functions (GAF) and higher sores of PSQI total scale and subscales of sleep time,sleep disorder and daytime function(P<0.05).But there was no significant difference on gender,educational level,the way of living ,rural or town,marital status between those two groups(P>0.05).Conclusions In dysthymic disorder,the prevalence of double depression is not low.Double depression comorbid with other mental disorders causes more severe social function damage and thus deserve more attention.更多还原