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重性抑郁障碍与精神分裂症共病:患病率及临床特征。

Co-Morbidity between Major Depression and Schizophrenia: Prevalence and Clinical Characteristics.

机构信息

Department of Biostatistics & Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University Cerrahpaşa and Istanbul Medipol University, International School of Medicine, 34098 Cerrahpasa-Istanbul, Turkey,

出版信息

Psychiatr Danub. 2020 Spring;32(1):78-83. doi: 10.24869/psyd.2020.78.

Abstract

BACKGROUND

The aim of this study was to explore the co-morbidity between Major Depressive Disorder (MDD) and Schizophrenia (SZ) among a large number of patients describing their clinical characteristics and rate of prevalence.

SUBJECTS AND METHODS

A cohort-study was carried out on 396 patients affected by MDD and SZ who consecutively attended the Department of Psychiatry, Rumeilah Hospital in Qatar. We employed the World Health Organization - Composite International Diagnostic Interview (WHO-CIDI) and the Structured Clinical Interview for DSM-5 (SCID-5) for diagnoses. Patients were also grouped in MDD patients with and without co-morbid SZ (MDD vs MDD/SZ) for comparisons.

RESULTS

A total of 396 subjects were interviewed. MDD patients with comorbid SZ (146(36.8%)) were 42.69±14.33 years old whereas MDD without SZ patients (250 (63.2%)) aged 41.59±13.59. Statistically significant differences between MDD with SZ patients and MDD without SZ patients were: higher BMI (Body Mass Index) (p=0.025), lower family income (p=0.004), higher rate of cigarette smoking (p<0.001), and higher level of consanguinity (p=0.023). Also, statistically significant differences were found in General Health Score (p=0.017), Clinical Global Impression-BD Score (p=0.042), duration of illnesses (p=0.003), and Global Assessment of Functioning (p=0.012). Rates of anxiety dimensions (e.g.: general anxiety, agoraphobia, somatisation, etc.), mood dimensions (e.g.: major depression, mania, oppositional defiant behaviour, Bipolar disorder), Attention Deficit Hyperactivity Disorder, psychotic and personality dimensions were higher among MDD with SZ patients than MDD without SZ.

CONCLUSION

This study confirms that MDD with SZ is a common comorbidity especially among patients reporting higher level of consanguinity. MDD/SZ comorbidity presents unfavourable clinical characteristics and higher levels of morbidity at rating scales.

摘要

背景

本研究旨在探讨大量患者中重度抑郁障碍(MDD)与精神分裂症(SZ)的共病情况,描述其临床特征和患病率。

对象和方法

对连续就诊于卡塔尔鲁梅拉医院精神科的 396 例 MDD 和 SZ 患者进行了队列研究。我们采用世界卫生组织-复合国际诊断访谈(WHO-CIDI)和精神障碍诊断与统计手册第五版结构化临床访谈(SCID-5)进行诊断。还将患者分为 MDD 伴和不伴共病 SZ(MDD 与 MDD/SZ)两组进行比较。

结果

共对 396 名患者进行了访谈。伴共病 SZ 的 MDD 患者(146 例,36.8%)年龄为 42.69±14.33 岁,而不伴 SZ 的 MDD 患者(250 例,63.2%)年龄为 41.59±13.59。伴 SZ 的 MDD 患者与不伴 SZ 的 MDD 患者之间存在统计学显著差异:更高的体重指数(BMI)(p=0.025)、更低的家庭收入(p=0.004)、更高的吸烟率(p<0.001)和更高的近亲结婚率(p=0.023)。同时,一般健康评分(p=0.017)、临床总体印象-BD 评分(p=0.042)、疾病持续时间(p=0.003)和总体功能评估(p=0.012)也存在统计学显著差异。伴 SZ 的 MDD 患者在焦虑维度(如广泛性焦虑、广场恐怖症、躯体化等)、情绪维度(如重度抑郁症、躁狂症、对立违抗行为、双相障碍)、注意力缺陷多动障碍、精神病和人格维度的发生率均高于不伴 SZ 的 MDD 患者。

结论

本研究证实,MDD 伴 SZ 是一种常见的共病,尤其是在近亲结婚率较高的患者中。MDD/SZ 共病表现出不良的临床特征和更高的疾病严重程度评分。

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