上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2015, Vol. 35 ›› Issue (10): 1508-.doi: 10.3969/j.issn.1674-8115.2015.10.015

• 论著（临床研究） • 上一篇    下一篇

老年期双相抑郁与单相抑郁患者临床特点的对照研究

洪波,李冠军,岳玲,安娜,王静华   

  1. 上海交通大学 医学院附属精神卫生中心老年科， 上海200030
  • 出版日期:2015-10-20 发布日期:2015-12-22
  • 通讯作者: 王静华, 电子信箱: jinghuazm5@qq.com
  • 作者简介: 王静华, 电子信箱: jinghuazm5@qq.com
  • 基金资助:

    上海市科委医学引导类项目（13401906200）；上海市精神卫生中心院级课题（2014-YJ-06）

Comparative study on clinical characteristics of elderly patients with unipolar depression and bipolar depression

HONG Bo, LI Guan-jun, YUE Ling, AN Na, WANG Jing-hua   

  1. Department of Geriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai200030, China
  • Online:2015-10-20 Published:2015-12-22
  • Supported by:

    Medical Guidance Project of Science Technology Commission of Shanghai Municipality, 13401906200; Foundation of Shanghai Mental Health Center, 2014-YJ-06

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摘要：

目的探讨老年期双相抑郁与单相抑郁障碍患者临床特点的差异。方法回顾性地分析2014年1月1日至2015年5月31日在上海市精神卫生中心老年科住院的21例双相抑郁（BD）和30例单相抑郁（UD）患者的人口学特征及临床资料，比较两组之间的差异。结果BD组平均发病年龄低于UD组（P<0.05），而总病程、总发作次数的均值均高于UD组，差异具有统计学意义（P<0.01）；BD组伴有精神病性症状的患者比例高于UD组，差异具有统计学意义（P<0.05）；BD组平均发病至确诊时间高于UD组，差异具有统计学意义（P<0.01），BD组中双相Ⅱ型占66.7%，双相Ⅱ型患者的误诊率为78.5%；BD组的社会支持评定量表得分低于UD组，差异具有统计学意义（P<0.05）。两组患者在共病躯体疾病、脑血管病高危因素、家族遗传史及临床表现伴忧郁性特征、非典型特征上的差异不具有统计学意义。结论老年期双相抑郁与单相抑郁在临床特点上存在差异，可能是老年双相抑郁的危险因素；老年期双相障碍患者社会支持系统更差，更需要得到广泛关注。

关键词: 老年, 双相抑郁, 单相抑郁, 临床特点

Abstract:

Objective To investigate the differences of clinical characteristics between elderly patients with unipolar depression (UD) and bipolar depression (BD).MethodsThe demographic characteristics and clinical data of 21 inpatients with BD and 30 inpatients with UD of the geriatrics department of Shanghai Mental Health Center from January 1, 2014 to May 31, 2015 were retrospectively analyzed to compare the differences between BD group and UD group.ResultsThe mean onset age of the BD group was younger than that of the UD group (P<0.05), while the mean duration of total course of disease was longer than that of the UD group and the mean number of onset was larger than that of the UD group (P<0.01). The differences were statistically significant. The percentage of patients with psychotic symptoms of the BD group was higher than that of the UD group (P<0.05) and the differences were statistically significant. The mean time between onset and definite diagnosis of the BD group was longer than that of the UD group (P<0.01) and the differences were statistically significant. In the BD group, patients with bipolar Ⅱ disorder accounted for 66.7% and the misdiagnose rate of them was 78.5%. The mean score of Social Support Rating Scale of the BD group was lower than that of the UD group (P<0.05) and the difference was statistically significant. The differences of comorbid somatic diseases, risk factors of cerebrovascular diseases, family history, and clinical manifestations with depressive characteristics and atypical characteristics of two groups were not statistically significant.ConclusionClinical characteristics between elderly patients with unipolar depression and bipolar depression are different, which may be risk factors of elderly patients with bipolar depression. The social support system of elderly patients with bipolar depression is poor and needs more attention.

Key words: elderly, bipolar depression, unipolar depression, clinical characteristics