單相抑郁與雙相抑郁的臨床特征及預后比較

劉海燕

[關鍵詞] 單相抑郁;雙相抑郁;臨床特征;預后

[中圖分類號] R749.4? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）22-0102-03

Comparison of clinical features and prognosis between unipolar depression and bipolar depression

LIU Haiyan

Guilin Mental Health Center in Guangxi Zhuang Autonomous Region， Guilin? 541001，China

[Abstract] Objective To investigate the differences in clinical features and prognosis between unipolar depression and bipolar depression in order to provide references for clinical diagnosis and treatment. Methods Forty-seven patients with unipolar depression admitted to our hospital from January 2018 to January 2020 were selected as group A， and forty-seven patients with bipolar depression admitted to our hospital during the same period were selected as group B. The clinical data of the two groups were retrospectively investigated and the differences were compared. The clinical characteristics of the two groups were summarized. In addition， the two groups were treated with medication combined with psychological intervention. The efficacies of the two groups were followed up to evaluate the prognosis. Results In group B， the onset age was （21.70±5.14） years old， earlier than that of （25.39±8.46）years old in group A， with statistically significant differences（P<0.05）; HAMD-17 insight factor score ，rate of family history of bipolar disorder ， rate of mood instability ， rate of psychotic symptoms in group B were higher than those in group A， with statistically significant differences（P<0.05）. After treatment， the HAMD-17 score in group A was（9.67±4.42） points， which was lower than that of （14.15±3.78） points in group B， with statistically significant differences（P<0.05）. Conclusion There are significant differences in the clinical characteristics of unipolar depression and bipolar depression. Bipolar depression has a relatively early onset age， relatively more severe cognitive impairment， and is often accompanied by mood instability and psychotic symptoms， with relatively unsatisfactory prognosis.

[Key words] Unipolar depression; Bipolar depression; Clinical features; Prognosis

抑郁發作是臨床常見心境障礙性疾病，患者以顯著而持久的心境低落為主要臨床特征，重者可產生自殺傾向，嚴重威脅生命健康。依據癥狀表現不同，抑郁發作可分為單相抑郁和雙相抑郁兩種，前者為單純抑郁發作，患者無躁狂癥狀，后者也稱躁狂抑郁癥，患者抑郁與躁狂常反復交替發作，心境在兩極間波動，情緒起伏明顯。有研究顯示，在雙相障礙患者中，抑郁發作起病的患者數量是躁狂發作起病患者的10倍[1]，在臨床上更為多見，而雙相抑郁發作在抑郁發作時，癥狀表現很難與單相抑郁發作區分。目前，臨床尚未明確單相抑郁與雙相抑郁的病因病機，有學者嘗試從分子生物學角度分析兩者差異，但至今沒有公認結果[2]。近年來，臨床開始嘗試從臨床特征角度探討兩者的不同，而了解兩種疾病的臨床特點，也可以為鑒別診斷提供一定的線索和依據。本研究現以2018年1月至2020年1月我院84例抑郁發作患者為例，對比分析兩種疾病的臨床特點及預后情況，現報道如下。