心境障碍问卷和32项轻躁狂症状清单在抑郁症患者中的应用
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国家自然科学基金项目(81901355)


Application of Mood Disorder Questionnaire and 32 Item Hypomania Checklist in patients diagnosed as major depressive disorder
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    摘要:

    目的 分析心境障碍问卷(MDQ)和 32 项轻躁狂症状清单(HCL-32)在精神病专科医院 抑郁症患者中筛查轻躁狂 / 躁狂症状的检出率差异、阴性与阳性患者临床特征的差异。方法 选取 2014 年 9 月至 2015 年 12 月于首都医科大学附属北京安定医院住院或门诊就诊的 105 例抑郁症患者为 研究对象,使用MDQ和HCL-32 调查患者既往轻躁狂/躁狂症状,其中MDQ总分≥ 7 分、HCL-32 总分≥ 14 分为既往轻躁狂 / 躁狂症状阳性,比较 2 个量表的阳性检出率、阳性与阴性患者的临床特征。采用 Cronbach's α 系数检验量表信度。结果 MDQ 的 Cronbach's α 系数为 0.784(95%CI:0.718~0.840,P< 0.01),HCL-32 的 Cronbach's α 系 数 为 0.943(95%CI:0.926~0.958,P< 0.01)。MDQ 筛 查 的 阳 性 率 为 15.24%(16/105),低于 HCL-32 筛查的 40.95%(43/105),差异有统计学意义(P< 0.01)。2 个量表的一致性 较低,差异有统计学意义(Kappa=0.281,P< 0.01)。MDQ 筛查阳性的患者中,伴有自杀观念、企图或行 为者占 7/16,伴不典型抑郁症状者占 6/16,高于阴性患者的 29.21%(26/89)和 13.48%(12/89),差异有统计 学意义(P< 0.05)。结论 HCL-32 对抑郁症患者既往轻躁狂 / 躁狂症状的检出率高于 MDQ,并且筛查阳 性的抑郁症患者的自杀风险高,伴不典型抑郁特征。

    Abstract:

    Objective To investigate difference between Mood Disorder Questionnaire (MDQ) and 32 Items Hypomania Check List (HCL-32) in screening manic/hypomanic symptoms in patients with depressive disorders in psychiatric hospitals and detection rate, as well as the difference in clinical characteristics between negative and positive patients. Methods A total of 105 patients with depressive disorders in the inpatient department and outpatient of Beijing Anding Hospital Affiliated to Capital Medical University from September 2014 to December 2015 were selected as the research subjects. MDQ and HCL-32 were applied to investigate previous hypomanic/manic symptoms. The total score of MDQ ≥ 7 and the total score of HCL- 32 ≥ 14 were positive for previous hypomanic/manic symptoms. The positive detection rate of the two scales and the clinical characteristics of positive and negative patients were compared. The reliability of the scale was tested by Cronbach's α. Results The Cronbach's α of the MDQ was 0.784 (95%CI=0.718-0.840, P < 0.01); the Cronbach's α of the HCL-32 was 0.943 (95%CI=0.926-0.958, P < 0.01). The positive rate of MDQ screening was 15.24% (16/105), which is lower than that of HCL-32 screening positive rate 40.95% (43/105), and the difference was statistically significant (P < 0.01). The consistency of the two scales is low,and the difference is statistically significant (Kappa=0.281, P< 0.01). Among the positive patients screened by MDQ, 7/16 was accompanied by suicidal ideas, attempts or behaviors, and 6/16 was accompanied by atypical depressive symptoms, which was higher than 29.21% (26/89) and 13.48% (12/89) of the negative patients, and the difference was statistically significant (P< 0.05). Conclusions The detection rate of previous hypomania/ mania symptoms in patients with depression by HCL-32 is higher than that of MDQ, and depression patients with positive screening have a high risk of suicide, accompanied by atypical depression characteristics.

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付兆燕,毛珍,孙悦,李峰,李田,王传跃,薄奇静.心境障碍问卷和32项轻躁狂症状清单在抑郁症患者中的应用[J].神经疾病与精神卫生,2022,22(8):
DOI :10.3969/j. issn.1009-6574.2022.08.004.

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  • 在线发布日期: 2022-08-23