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在中国,重度抑郁症的躯体症状存在差异。

Somatic symptoms vary in major depressive disorder in China.

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China; Shanghai Changning Mental Health Center, No 229, Xiehe Road, Changning District, Shanghai 200042, PR China.

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China.

出版信息

Compr Psychiatry. 2018 Nov;87:32-37. doi: 10.1016/j.comppsych.2018.08.013. Epub 2018 Aug 28.

Abstract

PURPOSE

This study aimed to investigate the clinical characteristics of somatic symptoms of patients in China who suffer from major depressive disorder (MDD).

METHOD

3273 patients who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) MDD were recruited from 16 general hospitals and 16 mental health centers in China. Physicians and patients completed complementary customized depression disorder symptomatology questionnaires assessing the clinical characteristics of patients with MDD.

RESULT

  1. In this study we analyzed physician-recorded data. The major somatic symptoms in patients with MDD in China were insomnia (64.6%), pre-verbal physical complaints (46.9%), weight loss (38.5%), low appetite (37.6%), circulatory system complaints (31.3%), headache (31.3%), hyposexuality (31.0%), gastrointestinal symptom complaints (29.6%), and respiratory system complaints (29.6%). 2. Compared with MDD patients who sought medical help from mental health centers, MDD patients who sought medical help from general hospitals were more likely to suffer from urinary system complaints, headache, sensory system complaints, trunk pain, and nervous system complaints. A lower prevalence rate of insomnia and hyposexuality was also observed among MDD patients who visited general hospitals (p < .05). 3. Patients aged from 40 to 54 had the highest probability of pre-verbal physical complaints, respiratory system complaints, trunk pain, hyposexuality, limb pain and other pain conditions, while patients over 55 years of age had the lowest prevalence respiratory system complaints, hyposexuality, and other pain conditions, and they also had the highest rate of low appetite and insomnia. 4. Female patients appeared to exhibit higher rates of pre-verbal physical complaints, low appetite, and insomnia than male patients, but had fewer urinary systems complaints than male patients (p < .05).

CONCLUSION

The major somatic symptoms in patients with MDD in China are insomnia, pre-verbal physical complaints, weight loss, low appetite, circulatory system complaints, headache, hyposexuality, gastrointestinal system complaints, and respiratory system complaints. These symptoms vary by the type of medical setting to which patients present, and well as by age, and gender.

摘要

目的

本研究旨在探讨中国患有重性抑郁障碍(MDD)患者躯体症状的临床特征。

方法

从中国 16 家综合医院和 16 家精神卫生中心招募了 3273 名符合精神障碍诊断与统计手册(DSM-IV)MDD 诊断标准的患者。医生和患者完成了互补的定制抑郁障碍症状学问卷,以评估 MDD 患者的临床特征。

结果

  1. 本研究分析了医生记录的数据。中国 MDD 患者的主要躯体症状为失眠(64.6%)、言语前躯体抱怨(46.9%)、体重减轻(38.5%)、食欲减退(37.6%)、循环系统抱怨(31.3%)、头痛(31.3%)、性欲减退(31.0%)、胃肠道症状抱怨(29.6%)和呼吸系统抱怨(29.6%)。2. 与从精神卫生中心寻求医疗帮助的 MDD 患者相比,从综合医院寻求医疗帮助的 MDD 患者更易出现泌尿系统抱怨、头痛、感觉系统抱怨、躯干疼痛和神经系统抱怨。同时,也观察到综合医院就诊的 MDD 患者失眠和性欲减退的患病率较低(p<0.05)。3. 40 至 54 岁的患者出现言语前躯体抱怨、呼吸系统抱怨、躯干疼痛、性欲减退、四肢疼痛等疼痛情况的概率最高,而 55 岁以上的患者呼吸系统抱怨、性欲减退和其他疼痛情况的患病率最低,且食欲减退和失眠的发生率最高。4. 女性患者出现言语前躯体抱怨、食欲减退和失眠的比例高于男性患者,但泌尿系统抱怨的比例低于男性患者(p<0.05)。

结论

中国 MDD 患者的主要躯体症状为失眠、言语前躯体抱怨、体重减轻、食欲减退、循环系统抱怨、头痛、性欲减退、胃肠道系统抱怨和呼吸系统抱怨。这些症状因患者就诊的医疗机构类型以及年龄和性别而异。

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