沈宗霖程宇琪刘晓妍杨舒然叶靖许秀峰

首发未用药抑郁症患者大五人格特征对照研究☆

沈宗霖*程宇琪*刘晓妍*杨舒然*叶靖*许秀峰*

目的探讨首发未服药抑郁症患者的大五人格特征。方法采用大五人格量表简化版（neuroticism extraversion openness five-factor inventory，NEO-FFI），对112例首发未服药抑郁症患者及99名性别、年龄、文化背景相匹配的正常对照进行大五人格特征评估，汉密尔顿抑郁量表（Hamilton depression scale，HAMD）评定患者的抑郁症状。结果 患者组神经质维度得分高于对照组，而外向性、开放性、宜人性及责任感维度得分均低于对照组（P＜0.05）。Logistic回归分析示，抑郁症与高水平神经质（OR=1.106，95%CI：1.029～1.189）、低水平外向性（OR=0.809，95%CI：0.733～0.893）和宜人性（OR=0.870，95%CI：0.794～0.953）相关联（均P＜0.01）。线性回归分析示，HAMD评分仅与高水平神经质相关（B=0.121，P=0.003），发病年龄则与责任感维度得分相关（B=0.015，P= 0.001）。结论本研究确认了抑郁症患者人格维度与正常对照有差异，高水平神经质维度是首发抑郁症患者的重要人格因素特征，低水平责任感则可能与抑郁症发病年龄早有关。

抑郁症大五人格对照研究

【Abstract】Objective To explore the big five personality characteristics of the first-episode，treatment-naive major depressive disorder.Method Neuroticism Extraversion Openness Five-Factor Inventory（NEO-FFI）was used to assess the personality.A comparison was conducted between 112 first-episode，treatment-naive major depressive disorder （MDD）patients and 99 sex-，age-and education level-matched healthy controls（HC）.The Hamilton depression scale （HAMD）was used to evaluate patients’symptom.Result Compared with HC，the neuroticism score in MDD group was significantly higher，while the extraversion，openness，agreeableness and conscientiousness were significantly lower.Lo⁃gistic regression analysis showed that MDD was significantly associated with higher neuroticism（OR=1.106，95%CI：1.029～1.189，P=0.006）and lower extraversion（OR=0.809，95%CI：0.733～0.893，P＜0.001）and agreeableness（OR= 0.870，95%CI：0.794～0.953，P=0.003）.Linear regression showed that the HAMD score was significantly associated with higher neuroticism（B=0.121，P=0.003）.The onset age of MDD was significantly associated with conscientiousness（B= 0.015，P=0.001）.Conclusion This study confirms that the personality of MDD is different from HC.Higher neuroticism is an important personality facets in treatment-naive patients with first-episode MDD.The low conscientiousness might associate with early age of depression onset.

【Key words】Major depressive disorder Big five personality Comparison study

抑郁症（major depressive disorder，MDD）是一种发病机制不明的异质性疾病。研究认为人格特征通常不受环境影响，于成年早期形成后便一直稳定持续存在［1］。而meta分析表明抑郁症与高水平的神经质和低水平的责任感相关［2］，提示抑郁症患者可能具有独特的人格特征。关于中国汉族女性抑郁症的研究发现，忧郁型患者的神经质维度得分显著高于非忧郁型抑郁症患者［3］，并且神经质和外向性维度对女性复发性抑郁症有影响［4］。但国内尚缺乏对首发未用药抑郁症患者大五人格特征的对照研究，因此本研究对首发未用药抑郁症患者的大五人格特征与抑郁症、病情严重程度及发病年龄的关联进行分析，旨在探索患者的人格特征，为抑郁症的防治提供基础理论依据。……