单相抑郁与双相抑郁的临床特征及预后比较

刘海燕

[关键词] 单相抑郁;双相抑郁;临床特征;预后

[中图分类号] R749.4          [文献标识码] B          [文章编号] 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

抑郁發作是临床常见心境障碍性疾病，患者以显著而持久的心境低落为主要临床特征，重者可产生自杀倾向，严重威胁生命健康。依据症状表现不同，抑郁发作可分为单相抑郁和双相抑郁两种，前者为单纯抑郁发作，患者无躁狂症状，后者也称躁狂抑郁症，患者抑郁与躁狂常反复交替发作，心境在两极间波动，情绪起伏明显。有研究显示，在双相障碍患者中，抑郁发作起病的患者数量是躁狂发作起病患者的10倍[1]，在临床上更为多见，而双相抑郁发作在抑郁发作时，症状表现很难与单相抑郁发作区分。目前，临床尚未明确单相抑郁与双相抑郁的病因病机，有学者尝试从分子生物学角度分析两者差异，但至今没有公认结果[2]。近年来，临床开始尝试从临床特征角度探讨两者的不同，而了解两种疾病的临床特点，也可以为鉴别诊断提供一定的线索和依据。本研究现以2018年1月至2020年1月我院84例抑郁发作患者为例，对比分析两种疾病的临床特点及预后情况，现报道如下。