上海交通大学学报（医学版）

上海交通大学学报（医学版）

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早发型和晚发型难治性抑郁患者的临床特征比较

廖力维，吴志国，曹 岚，陈 俊，苑成梅，洪 武，张 晨，彭代辉，王 勇，方贻儒   

  1. 上海交通大学 医学院附属精神卫生中心， 上海 200030
  • 出版日期:2014-04-28 发布日期:2014-05-13
  • 通讯作者: 方贻儒, 电子信箱: yirufang@aliyun.com。
  • 作者简介:廖力维(1981—)， 男， 主治医师， 硕士; 电子信箱: liaoliwei81@gmail.com。
  • 基金资助:
    “十五”国家科技攻关计划(2004BA720A21-02)；国家高技术研究发展计划（“863”计划）(2006AA02Z430)；“十二五”国家科技支撑项目(2012BAI01B04)； 国家临床重点专科-上海市精神卫生中心（卫生部医政司2011-873）；上海市科委医学（西医）引导类项目（134119b0400）

Comparison of the clinical features of patients with early-onset and late-onset treatment-resistant depression

LIAO Li-wei, WU Zhi-guo, CAO Lan, CHEN Jun, YUAN Cheng-mei, HONG Wu, ZHANG Chen, PENG Dai-hui, WANG Yong, FANG Yi-ru   

  1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2014-04-28 Published:2014-05-13
  • Supported by:
    the“10th Five-year Plan” of National Key Technoloogy R&D program, 2004BA720A21-02; National High-tech R&D Program, 2006AA02Z430； the “12th Five-year Plan” of National Key Technologies R&D Program, 2012BAI01B04; National Key Clinical Disciplines at Shanghai Mental Health Center, OMA-MH, 2011-873; Medical
    Guidance Project of Science and Technology Commission of Shanghai Municipality, 134119b0400

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摘要：

目的 比较早发型与晚发型难治性抑郁患者的临床特点。方法 采用中位数切割法将370例成年难治性抑郁患者分为早发型组(n=193)和晚发型组(n=177)，对两组患者
的临床特征进行比较和分析。结果 与晚发型组比较,早发型组男性、性格内向及完成9年制义务教育者的构成比更高(P<0.001)；当前发作病程更长，分别为（17.32±25.94）个月和（12.47±18.42)个月(P=0.015)；与早发型组比较，晚发型组已婚者构成比和抑郁程度17项汉密尔顿抑郁量表(HAMD.17)总分和因子睡眠障碍得分均显著增高(P<0.001)，躯体共病构成比更高(P=0.008)。结论 早发型与晚发型难治性抑郁患者的临床特征存在差异，可能与其潜在的病理生理学机制有关。

关键词: 早发型, 晚发型, 难治性抑郁, 临床特征

Abstract:

Objective To compare the clinical features of patients with early-onset and late-onset treatment-resistant depression. Methods Three hundred and seventy adult patients with treatment-resistant depression were divided into the early-onset group (n=193) and late-onset group (n=177) by the median method. The clinical features of two groups were compared and analyzed. Results Compared to the late-onset group, the proportions of male, introverts, and patients who completed nine-year voluntary education of early-onset group were higher (P<0.001) and the current episodes were longer, i.e. (17.32±25.94) months and (12.47±18.42) months, respectively (P=0.015). Compared to the early-onset group, the proportion of married patients, Hamilton depressive scale-17 items (HAMD-17) scores of depression level, and factor sleep disorder scores of late-onset group were all significantly increased (P<0.001), and the proportion of physical comorbidities was much higher (P=0.008). Conclusion The clinical features of patients with early-onset and late-onset treatment-resistant depression are different. The differences may be relevant to the potential pathophysiological mechanisms.

Key words: early-onset, late-onset, treatment-resistant depression, clinical features