Grover Sandeep, Sahoo Swapnajeet, Mishra Kshirod K, Deep Raman, Nebhinani Naresh, Bhattacharya Ranjan, Aneja Jitender, Kalivayalil Roy A, Chaterjee Seshadri S, Menon Vikas, Subramanyam Alka A, Punnoose Varghese P, Desouza Avinash, Mehra Aseem, Subodh B N, Avasthi Ajit
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
Indian J Psychiatry. 2023 Jun;65(6):671-679. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_113_23. Epub 2023 Jun 19.
There is limited literature on the prevalence of mixed features in patients with depression, especially from countries in Asia. Our aim was to evaluate the prevalence of "mixed features" in patients with first-episode depression.
Patients with first-episode depression were evaluated for the presence of mixed features as per the Diagnostic and Statistical Manual (DSM)-5 criteria. They were additionally evaluated on Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS).
About one-sixth (16%) of the patients fulfilled the DSM-5 criteria for the mixed features specifier. The most common manic/hypomanic clinical feature was increased talkativeness or pressure of speech, followed by elevated expansive mood (12.5%), and inflated self-esteem or grandiosity was the least common feature (8.7%). Those with mixed features had higher prevalence of comorbid tobacco dependence and psychotic symptoms. In terms of frequency of depressive symptoms as assessed on HDRS, compared to those without mixed features, those with mixed features had higher frequency of symptoms such as depressed mood, insomnia during early hours of morning, work and activities, agitation, gastrointestinal somatic symptoms, genital symptoms, hypochondriasis, and poorer insight.
Mixed features specifier criteria were fulfilled by 16% patients with first-episode depression. This finding suggests that the extension of this specifier to depression can be considered as a useful step in understanding the symptom profile of patients with depression.
关于抑郁症患者混合特征患病率的文献有限，尤其是来自亚洲国家的相关文献。我们的目的是评估首发抑郁症患者中“混合特征”的患病率。
根据《精神疾病诊断与统计手册》（DSM）-5标准，对首发抑郁症患者进行混合特征的评估。此外，还使用汉密尔顿抑郁量表（HDRS）和杨氏躁狂量表（YMRS）对他们进行评估。
约六分之一（16%）的患者符合DSM-5混合特征说明符标准。最常见的躁狂/轻躁狂临床特征是言语增多或言语紧迫感，其次是情绪高涨（12.5%），而自尊膨胀或夸大观念是最不常见的特征（8.7%）。具有混合特征的患者共病烟草依赖和精神病性症状的患病率更高。在HDRS评估的抑郁症状频率方面，与没有混合特征的患者相比，具有混合特征的患者在情绪低落、凌晨失眠、工作与活动、激越、胃肠道躯体症状、生殖器症状、疑病症状以及自知力较差等症状方面的频率更高。
16%的首发抑郁症患者符合混合特征说明符标准。这一发现表明，将该说明符扩展至抑郁症可被视为理解抑郁症患者症状特征的有益举措。
