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关于人格解体水平的抑郁现象学。

Depressive phenomenology in regard to depersonalization level.

作者信息

Zikić Olivera, Cirić Snezana, Mitković Marija

机构信息

Clinic for Mental Health Protection, UCC Nis, 18000 Nis, Serbia.

出版信息

Psychiatr Danub. 2009 Sep;21(3):320-6.

Abstract

BACKGROUND

It has been found that in patients suffering from unipolar depression, associated depersonalization symptomatology is more intense compared to healthy controls, and also that there is a positive correlation between depression and depersonalization. According to data that may be found in the literature, there is a relatively high prevalence of depersonalization symptomatology in unipolar depressions. Our study was aimed at finding whether the presence of depersonalization was related to a specific phenomenological expression of depressive symptomatology in unipolar depression.

SUBJECTS AND METHODS

The study included 84 subjects suffering from unipolar depression without psychotic features. Based on the Cambridge Depersonalization Scale (CDS) score, the subjects were divided into two groups - a group with associated depersonalization (CDS>or=70) (40 subjects) and a group with subsyndromal depersonalization (CDS<70) (44 subjects), the later one being treated as a control group. The groups were compared in regard to the intensity of depressive symptomatology, depressive symptoms frequency and the depressive symptoms duration. The General Socio-Demographic Questionnaire, the Cambridge Depersonalization Scale and The Patient Health Questionnaire - 9 were used.

RESULTS

The depressive patients with depersonalization had predominantly severe episodes, almost all patients had feelings of sadness, insomnia, and decrease of energetic potentials. The biggest difference between the groups, in terms of greater number of manifest symptoms in the patients with depersonalization, was for psychomotor disturbances (agitation or retardation), insomnia, decrease of energetic potentials and concentration. At the same time, 75% of the subjects with associated depersonalization had anhedonia, sadness/dysphoria, insomnia and decrease of energetic potentials continuously present. Unlike this group, the control group subjects experienced sadness, appetite problems, concentration and motor behavior changes almost half as frequently. Particularly significant were the differences regarding suicidal thoughts. It was shown that in the group with depersonalization there was a higher percentage of patients with suicidal thoughts, mostly continuously present, which represent a significant suicidal risk factor.

CONCLUSION

Unipolar depression, associated with depersonalization is more severe in its intensity .It has a bigger number of manifest symptoms which have a tendency to continuous duration. A special focus is on the negative impact on the occurrence and lasting presence of suicidal thoughts.

摘要

背景

研究发现,与健康对照相比,单相抑郁症患者的相关人格解体症状更为严重,且抑郁症与人格解体之间存在正相关。根据文献中的数据,单相抑郁症中人格解体症状的患病率相对较高。我们的研究旨在探讨人格解体的存在是否与单相抑郁症中抑郁症状的特定现象学表现有关。

对象与方法

该研究纳入了84例无精神病性特征的单相抑郁症患者。根据剑桥人格解体量表(CDS)评分,将受试者分为两组——伴有相关人格解体的组(CDS≥70)(40例受试者)和亚综合征性人格解体组(CDS<70)(44例受试者),后者作为对照组。比较两组在抑郁症状强度、抑郁症状频率和抑郁症状持续时间方面的差异。使用了一般社会人口学问卷、剑桥人格解体量表和患者健康问卷-9。

结果

伴有人格解体的抑郁患者主要为重度发作,几乎所有患者都有悲伤感、失眠和精力下降。就人格解体患者表现出的更多症状而言,两组之间最大的差异在于精神运动障碍(激越或迟缓)、失眠、精力下降和注意力不集中。同时,75%伴有相关人格解体的受试者持续存在快感缺失、悲伤/烦躁不安、失眠和精力下降。与该组不同,对照组受试者经历悲伤、食欲问题、注意力和运动行为改变的频率几乎是前者的一半。关于自杀念头的差异尤为显著。结果表明,人格解体组中有自杀念头的患者比例更高,且大多持续存在,这是一个重要的自杀风险因素。

结论

与人格解体相关的单相抑郁症在强度上更为严重。其表现出的症状更多,且有持续存在的倾向。特别值得关注的是对自杀念头的发生和持续存在的负面影响。

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