【摘要】 目的 比较复发性抑郁、双相抑郁障碍患者的临床特点与临床伴随特征的差异。方法 采用简明国际神经精神访谈中文版（MINI）进行访谈，选取于2020年4月～2020年11月的15～65岁住院患者，其中复发性抑郁94例，双相抑郁障碍97例，采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（MAMA）、32项轻躁狂症状清单（HCL-32）及人格障碍的结构化临床访谈（SCID-II）中边缘性人格障碍的诊断条目评定患者的临床症状。计数资料采用x~2检验和Fisher确切概率法，计量资料采用t检验，对于非正态分布的资料采用非参数检验。结果 双相抑郁障碍首次为抑郁发作者占69.07%，发病年龄为21.64±10.42岁，显著早于复发性抑郁障碍的38.79±14.47岁（P<0.05），其中双相Ⅱ型患者发病年龄17.89±7.78岁显著早于双相I型患者的26.35±11.44岁（P<0.001）；复发性抑郁障碍HAMD总分23.79±4.44，显著高于双相抑郁障碍患者的22.45±4.61分（P<0.05），焦虑/躯体化和睡眠障碍因子分显著高于双相抑郁障碍（P<0.05）。双相抑郁障碍伴有混合特征（30.93%）、非典型特征（17.53%）、精神病性特征（23.71%）的比例显著高于复发性抑郁障碍（1.06%、0.00%、8.51%,P<0.05）；伴有自伤行为（47.42%）、自杀行为（43.30%）、边缘性人格障碍（43.30%）的比例显著高于复发性抑郁障碍（8.51%、22.34%、11.70%,P<0.05）。结论 双相抑郁障碍具有发病年龄早，更多的伴有混合特征、非典型特征、精神病性、边缘性人格特征，自杀自伤突出；复发性抑郁障碍伴忧郁特征明显，抑郁严重程度偏重，焦虑/躯体化、睡眠障碍症状明显。更多还原

【Abstract】 Objective To compare the clinical features and clinical concomitant features of patients with recurrent depression and bipolar depression disorder. Methods The International Neuropsychiatric Interview(MINI) was used to conduct interviews. The inpatients aged 15 to 65 were selected from April 2020 to November 2020, including 94 cases of recurrent depression and 97 cases of bipolar depressive disorder. Clinical symptoms were assessed using the Hamilton Depression Scale(HAMD), the Hamilton Anxiety Scale(MAMA), the Hypomaniac Symptoms List 32-item(HCL-32), and the diagnostic items of borderline personality disorder in the Structured Clinical Interview for DSM-IV Axis II Personality Disorders(SCIDII). The x~2 test and Fisher’s exact probability method were used for counting data, t test was used for measurement data, and non-parametric test was used for data with non-normal distribution. Results The first onset of bipolar depression was 69.07%, and the age of onset was 21.64±10.42 years,which was significantly earlier than that of recurrent depressive disorder(38.79±14.47 years)(P<0.05). The onset age of bipolar II patients was 17.89±7.78 years earlier than that of bipolar I patients(26.35±11.44 years)(P<0.001). HAMD score of recurrent depressive disorder was 23.79±4.44,which was significantly higher than that of bipolar disorder(22.45±4.61)(P<0.05). Factor scores of anxiety/somatization and sleep disorder were significantly higher than those of bipolar disorder(P<0.05). The proportion of bipolar depressive disorder with mixed features(30.93%), atypical features(17.53%) and psychotic features(23.71%) was significantly higher than that of recurrent depressive disorder(1.06%, 0.00%, 8.51%, P<0.05).The proportions of self-injury(47.42%), suicide(43.30%) and borderline personality disorder(43.30%) were significantly higher than those of recurrent depressive disorder(8.51%, 22.34%, 11.70%, P<0.05). Conclusion Bipolar depression is associated with early onset, mixed characteristics,atypical characteristics, psychosis, borderline personality, and suicide self-injury. Recurrent depressive disorder is characterized by depression, severe depression, anxiety/somatization, and sleep disorders.更多还原