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单相重度抑郁症和双相情感障碍病情缓解期患者的生活质量。

Quality of life in euthymic patients with unipolar major depressive disorder and bipolar disorder.

作者信息

Bo Qijing, Tian Lu, Li Feng, Mao Zhen, Wang Zhimin, Ma Xin, Wang Chuanyue

机构信息

The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China.

Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2019 Jun 24;15:1649-1657. doi: 10.2147/NDT.S201567. eCollection 2019.

Abstract

This study aimed to compare quality of life (QOL) between patients with major depressive disorder (MDD) in remission and patients with bipolar disorder (BD) in remission, and to explore the relationship between QOL and demographic, clinical, and cognitive variables. This study included 49 euthymic patients with MDD, 59 euthymic patients with BD, and 52 healthy controls (HC). The 17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), and Young Mania Rating Scale (YMRS) were used to assess symptoms of depression, anxiety, and mania respectively. QOL was assessed with the Chinese version of the World Health Organization Quality of Life Scale Brief (WHOQOL-BREF). Cognitive function was assessed with the repeated neuropsychological assessment scale (RBANS). Compared with HC, patients with MDD had lower overall and subdomain scores (except ENVIR) on the WHOQOL-BREF (<0.05). The BD group had decreased overall WHOQOL-BREF scores and decreased PHYS and SOCIL subdomain scores (<0.05). PSYCH scores were lower in patients with MDD, compared with patients with BD (<0.05). Among patients with MDD, HAMD score was negatively correlated with all domains on the WHOQOL-BREF. Marital status was associated with an increase in subdomain scores on the PSYCH and ENVIR subdomains. In the BD group, attention on the RBANS correlated negatively with PSYCH score; age correlated negatively with SOCIL. QOL of patients with MDD and BD in remission is inferior to that of the normal population. QOL among MDD is inferior to that among BD. Marital status was associated with increased QOL among MDD, but not among BD. Residual symptoms related to depression or anxiety decreased QOL in both MDD and BD. More attention should be paid to the QOL of patients with mood disorders, especially MDD, even during euthymic periods.

摘要

本研究旨在比较缓解期重度抑郁症(MDD)患者和缓解期双相情感障碍(BD)患者的生活质量(QOL),并探讨生活质量与人口统计学、临床和认知变量之间的关系。本研究纳入了49例心境正常的MDD患者、59例心境正常的BD患者和52名健康对照者(HC)。分别使用17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)和杨氏躁狂量表(YMRS)评估抑郁、焦虑和躁狂症状。采用中文版世界卫生组织生活质量简表(WHOQOL-BREF)评估生活质量。使用重复神经心理评估量表(RBANS)评估认知功能。与HC相比,MDD患者在WHOQOL-BREF上的总体和子领域得分较低(ENVIR除外,P<0.05)。BD组的WHOQOL-BREF总体得分以及PHYS和SOCIL子领域得分降低(P<0.05)。与BD患者相比,MDD患者的PSYCH得分较低(P<0.05)。在MDD患者中,HAMD得分与WHOQOL-BREF的所有领域均呈负相关。婚姻状况与PSYCH和ENVIR子领域的子领域得分增加有关。在BD组中,RBANS上的注意力与PSYCH得分呈负相关;年龄与SOCIL呈负相关。缓解期MDD和BD患者的生活质量低于正常人群。MDD患者的生活质量低于BD患者。婚姻状况与MDD患者生活质量的提高有关,但与BD患者无关。与抑郁或焦虑相关的残留症状降低了MDD和BD患者的生活质量。即使在心境正常期间,也应更加关注情绪障碍患者,尤其是MDD患者 的生活质量。

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