不典型抑郁症临床误诊分析OA
Analysis of Clinical Misdiagnosis of Atypical Depression
目的 探讨不典型抑郁症临床特点,分析误诊原因及应对策略.方法 回顾性分析 2020 年 6 月至2023 年6 月初诊为其他精神心理或躯体疾病的10 例不典型抑郁症患者的临床资料.结果 10 例中,4 例因长期疲劳和注意力不集中被误诊为慢性疲劳综合征;3 例因情绪波动和易怒被误诊为双相情感障碍;2 例以胃部不适为主诉被误诊为功能性胃肠病;1 例因过度睡眠及作息紊乱被误诊为睡眠障碍.所有患者在转诊至我院后,通过进一步检查确诊为不典型抑郁症.误诊时间1~3 个月.确诊后患者接受个体化对症治疗,6 个月随访显示9 例症状改善,1 例在治疗初期症状缓解不明显,经药物调整后改善.结论 不典型抑郁症临床表现复杂且多样,易与其他精神及躯体疾病混淆;提高对其特征性症状的认识,结合标准化心理量表及多学科协作,有助于降低误诊率,提高诊断准确性.
Objective To investigate the clinical characteristics of atypical depression,and to analyze the causes of misdiagnosis and countermeasures.Methods From June 2020 to June 2023,the clinical data of 10 patients with atypical de-pression who were initially diagnosed with other mental,psychological or physical diseases were retrospectively analyzed.Results Among the 10 patients,4 patients were misdiagnosed as chronic fatigue syndrome due to long-term fatigue and inat-tention.Three patients were misdiagnosed as bipolar disorder due to mood swings and irritability.Two patients with stomach discomfort as the main complaint were misdiagnosed as functional gastrointestinal disease.One patient was misdiagnosed as sleep disorder due to excessive sleep and sleep disturbance.After referral to the Department of Psychology,all patients were diagnosed with atypical depression through further examination.The duration of misdiagnosis was 1-3 months.After diagnosis,the patients received individualized symptomatic treatment,and the 6-month follow-up showed that the symptoms of 9 patients improved significantly,and 1 patient had no obvious relief in the early stage of treatment,but significantly improved after drug adjustment.Conclusion The clinical manifestations of atypical depression are complex and varied,which are easily confused with other mental and physical diseases.To improve the understanding of the characteristic symptoms,combined with stand-ardized psychological scale and multidisciplinary collaboration,is helpful to reduce the misdiagnosis rate and improve the diag-nostic accuracy.
樊伊楠;陶桂凤;孙大伟;彭龙颜;历跃;姜雨微
163000 黑龙江大庆,大庆市第三医院中医心理病区163000 黑龙江大庆,大庆市第三医院成人心理一病区163000 黑龙江大庆,大庆市第三医院中医心理病区163000 黑龙江大庆,大庆市第三医院中医心理病区163000 黑龙江大庆,大庆市第三医院成人心理一病区163000 黑龙江大庆,大庆市第三医院精神四病区
临床医学
不典型抑郁症误诊疲劳综合征,慢性双相情感障碍功能性胃肠病睡眠障碍抑郁自评量表汉密尔顿抑郁量表
Atypical depressionMisdiagnosisFatigue syndrome,chronicBipolar disorderFunctional gastroin-testinal diseaseSleep disordersSelf-rating depression scaleHamilton depression scale
《临床误诊误治》 2025 (6)
6-11,16,7
大庆市指导性科技计划项目(zdy-2023-29)
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