单双相抑郁障碍病人躯体化症状的状况
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摘要
目的:调查单双相抑郁障碍病人的躯体化症状的状况及特点。方法:采用便利抽样方法,用一般情况问卷、躯体症状问卷(SSI)、汉密尔顿抑郁量表(HAMD),对94例抑郁障碍病人的一般资料、躯体化症状、抑郁情绪进行调查。所有资料输入SPSS20.0进行描述性和相关性统计分析。结果:病人躯体症状的均分为(48.16±15.121)分,26.6%的病人的躯体化症状已达中重度。抑郁障碍病人的躯体症状与饮食情况、重大生活事件、用药不良反应出现的症状有关(P<0.05～P<0.01);饮食状况良好者其躯体症状总分和非疼痛躯体症状分数明显低于饮食情况一般和食欲下降者(P<0.05～P<0.01);一年内经历2次以上重大生活事件者,其疼痛症状分数明显高于未经历或经历1次生活事件者(P<0.05);存在3种及以上用药不良反应的病人,其躯体化症状总分和非疼痛症状分数显著高于无药物不良反应或仅有1种不良反应者(P<0.01);躯体症状总分、疼痛维度和非疼痛维度躯体症状和病人的抑郁程度均呈正相关(r=0.337、0.325、0.316,P<0.01)。结论:躯体症状在抑郁障碍病人中较为普遍。护理人员重视病人饮食情况、药物不良反应的管理,及经历重大生活事件病人的情绪管理,从而促进抑郁障碍病人的全面康复。
Objective:To investigate the status and characteristics of somatic symptoms in patients with unipolar and bipolar depressive disorders.Methods:The general information,somatic symptoms and depression in 94 patients with depressive disorders were investigated using the symptom questionnaire(SSI),Hamilton Depression Scale(HAMD) and general questionnaire,and all data were analyzed using SPSS20.0 software.Results:The average score of SSI of patients was(48.16±15.121),and the somatic symptoms of 26.6% patients were the moderate to severe levels.The somatic symptoms of patients with depressive disorders were significantly correlated with the diet,life events and side effects of medication(P<0.05 to P<0.01).The total score of somatic symptoms and non-pain somatic symptom score in patients with good diet were significantly lower than those in patients with normal diet and anorexic(P<0.05 to P<0.01).The score of pain symptoms in patients with experiencing more than 2 major life events in one year was significantly higher than that in patients without experiencing or with experiencing one major life event(P<0.05).The total score of somatization symptoms and non-pain symptoms score in patients with three or more adverse drug reactions were significantly higher than those in patients without or with one adverse drug reaction(P<0.01).The total score of somatic symptoms,dimension of pain and non-pain were positively correlated with the depression degree of patients(r=0.337,0.325 and 0.316,P<0.01).Conclusions:Somatic symptoms is more common in patients with depressive disorder.The diet,management of adverse drug reactions,and emotional management of patients experiencing major life events should be concerned by nurses,so that the comprehensive rehabilitation of patients with depressive disorders is promoted.
Objective:To investigate the status and characteristics of somatic symptoms in patients with unipolar and bipolar depressive disorders.Methods:The general information,somatic symptoms and depression in 94 patients with depressive disorders were investigated using the symptom questionnaire(SSI),Hamilton Depression Scale(HAMD) and general questionnaire,and all data were analyzed using SPSS20.0 software.Results:The average score of SSI of patients was(48.16±15.121),and the somatic symptoms of 26.6% patients were the moderate to severe levels.The somatic symptoms of patients with depressive disorders were significantly correlated with the diet,life events and side effects of medication(P<0.05 to P<0.01).The total score of somatic symptoms and non-pain somatic symptom score in patients with good diet were significantly lower than those in patients with normal diet and anorexic(P<0.05 to P<0.01).The score of pain symptoms in patients with experiencing more than 2 major life events in one year was significantly higher than that in patients without experiencing or with experiencing one major life event(P<0.05).The total score of somatization symptoms and non-pain symptoms score in patients with three or more adverse drug reactions were significantly higher than those in patients without or with one adverse drug reaction(P<0.01).The total score of somatic symptoms,dimension of pain and non-pain were positively correlated with the depression degree of patients(r=0.337,0.325 and 0.316,P<0.01).Conclusions:Somatic symptoms is more common in patients with depressive disorder.The diet,management of adverse drug reactions,and emotional management of patients experiencing major life events should be concerned by nurses,so that the comprehensive rehabilitation of patients with depressive disorders is promoted.
引文
[1] 郝伟,于欣.精神病学 [M].7版.北京:人民卫生出版社,2015.
[2] 王新玲,陈炜.皮肤交感反应和R-R间期变化率评估双相障碍的临床治愈[D].杭州:浙江大学,2013.
[3] KESSLER RC,BROMET EJ.The epidemiology of depression across cultures[J].Annu Rev Public Health,2013,34:119.
[4] Health in 2015:from MDGs,Millennium Development Goals to SDGs,Sustainable Development Goals[EB/OL].Geneva:World Health Organization,2015:153.
[5] 李闻天,张洁.德国综合性医院医学无法解释的躯体症状患者与其他心理障碍患者的心理治疗服务时长差异性分析[J].中国全科医学,2016,19(32):3902.
[6] 赵靖平.抑郁症是可治性疾病[J].中华精神科杂志,2011,44(1):47.
[7] 江开达.精神病学高级教程[M].北京:人民军医出版社,2009.
[8] 李丽娜,高凌云,曾宏翔.综合医院医护人员对抑郁症认知调查[J].中国健康心理学杂志,2015,23(13):1634.
[9] NOVICK D,MONTGOMERY W,AGUADO J,et al.Which somatic symptoms are associated with an unfavorable course in Asian patients with major depressive disorder?[J].J Affect Disord,2013,149(1/3):182.
[10] 张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2005.
[11] CABALLERO L,ARAGONES E,GARCIA-CAMPAYO J,et al.Prevalence,characteristics,and attribution of somatic symptoms in Spanish patients with major depressive disorder seeking primary health care[J].Psychosomatics,2008,49(6):520.
[12] WENZEL A,STEER RA,BECK AT.Are there any gender differen cesin fbquency of self-reponed somatic symploms of depression?[J].J Affect Disord,2005,89(13):177.
[13] BAGAYOGO IP,INTERIAN A,ESCOBAR JI.Transcultural aspects of somatic symptoms in the context of depressive disorders[J].Adv Psychosom Med,2013,33:64.
[14] HINCHEY SA,JACKSON JL. A cohort study assessing difhcuIt patient encounters in a walk-in primary care clinic,predictors and outcomes[J]. J Gen Intem Med,2011,26(6):588.
[15] URRILA AS,KARLSSON L,KIVIRUUSU O,et al. Sleep complaints among adolescent outpatients with major depressive disorder[J]. Sleep Med,2012,13(7):816.
[16]顾桂英,曾德志,樊学文,等.抑郁症患者入院初期睡眠障碍的多因素分析[J].实用预防医学,2013,20(4):503.
[17] CARNEY RM,FREEDLAND KE. Are somatic symptoms of depression better predictors of cardiac events than cognitive symptoms in coronary heart disease?[J]. Psychosom Med,2012,74(1):33.
[18] MCCLINTOCK SM,HUSAIN MM,WISNIEWSKI SR,et al.Residual symptoms in depressed outpatients who respond by 50%but do not remit to antidepressant medication[J]. J Clin Psychopharmacol,2011,31(2):180.
[19] CONRADI HJ,ORMEL J,DE JONGE P. Presence of individual(residual)symptoms during depressive episodes and periods of remission:a 3-year prospective study[J]. Psychol Med,2011,41(6):1165.
[20] PAYKEL ES. Residual symptoms and relapse in depression[J].Medicographia,2009,31:157.
[21] BAIR MJ,ROBINSON RL,ECKERT GJ,et al. Impact of pain on depression treatment response in primary care[J]. Psychosom Med,2004,66(1):17.
[2] 王新玲,陈炜.皮肤交感反应和R-R间期变化率评估双相障碍的临床治愈[D].杭州:浙江大学,2013.
[3] KESSLER RC,BROMET EJ.The epidemiology of depression across cultures[J].Annu Rev Public Health,2013,34:119.
[4] Health in 2015:from MDGs,Millennium Development Goals to SDGs,Sustainable Development Goals[EB/OL].Geneva:World Health Organization,2015:153.
[5] 李闻天,张洁.德国综合性医院医学无法解释的躯体症状患者与其他心理障碍患者的心理治疗服务时长差异性分析[J].中国全科医学,2016,19(32):3902.
[6] 赵靖平.抑郁症是可治性疾病[J].中华精神科杂志,2011,44(1):47.
[7] 江开达.精神病学高级教程[M].北京:人民军医出版社,2009.
[8] 李丽娜,高凌云,曾宏翔.综合医院医护人员对抑郁症认知调查[J].中国健康心理学杂志,2015,23(13):1634.
[9] NOVICK D,MONTGOMERY W,AGUADO J,et al.Which somatic symptoms are associated with an unfavorable course in Asian patients with major depressive disorder?[J].J Affect Disord,2013,149(1/3):182.
[10] 张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2005.
[11] CABALLERO L,ARAGONES E,GARCIA-CAMPAYO J,et al.Prevalence,characteristics,and attribution of somatic symptoms in Spanish patients with major depressive disorder seeking primary health care[J].Psychosomatics,2008,49(6):520.
[12] WENZEL A,STEER RA,BECK AT.Are there any gender differen cesin fbquency of self-reponed somatic symploms of depression?[J].J Affect Disord,2005,89(13):177.
[13] BAGAYOGO IP,INTERIAN A,ESCOBAR JI.Transcultural aspects of somatic symptoms in the context of depressive disorders[J].Adv Psychosom Med,2013,33:64.
[14] HINCHEY SA,JACKSON JL. A cohort study assessing difhcuIt patient encounters in a walk-in primary care clinic,predictors and outcomes[J]. J Gen Intem Med,2011,26(6):588.
[15] URRILA AS,KARLSSON L,KIVIRUUSU O,et al. Sleep complaints among adolescent outpatients with major depressive disorder[J]. Sleep Med,2012,13(7):816.
[16]顾桂英,曾德志,樊学文,等.抑郁症患者入院初期睡眠障碍的多因素分析[J].实用预防医学,2013,20(4):503.
[17] CARNEY RM,FREEDLAND KE. Are somatic symptoms of depression better predictors of cardiac events than cognitive symptoms in coronary heart disease?[J]. Psychosom Med,2012,74(1):33.
[18] MCCLINTOCK SM,HUSAIN MM,WISNIEWSKI SR,et al.Residual symptoms in depressed outpatients who respond by 50%but do not remit to antidepressant medication[J]. J Clin Psychopharmacol,2011,31(2):180.
[19] CONRADI HJ,ORMEL J,DE JONGE P. Presence of individual(residual)symptoms during depressive episodes and periods of remission:a 3-year prospective study[J]. Psychol Med,2011,41(6):1165.
[20] PAYKEL ES. Residual symptoms and relapse in depression[J].Medicographia,2009,31:157.
[21] BAIR MJ,ROBINSON RL,ECKERT GJ,et al. Impact of pain on depression treatment response in primary care[J]. Psychosom Med,2004,66(1):17.