关键词:

抑郁症, 精神病性症状, 儿童期虐待, 影响因素, 预测模型

Abstract:

Objective　To analyze the correlation between depression with psychotic symptoms and childhood abuse and construct a prediction model. Methods　A total of 600 patients with depression admitted to Chang'an Hospital and Dali Shanda Psychiatric Hospital from February 2021 to February 2024 were selected as the study objects, including 208 males and 392 females, aged 21 to 50 (35.11±4.88) years. The patients were divided into a psychotic symptom group (65 cases) and a non-psychotic symptom group (535 cases) according to the 90-item Symptom Check List (SCL-90) score. General data of the patients were collected and compared through the electronic medical record system, including demographic characteristics (gender, age, body mass index, duration of depression, marital status, education, employment, family history of depression, and childhood abuse) and clinical characteristics (age of onset of depression, depression with anxiety, and depression with suicidal tendency). Independent sample t test and χ² test were used for statistical analysis. Multivariate logistic regression analysis was used to analyze the influencing factors of depression patients with psychotic symptoms, and a prediction model was constructed. The receiver operating characteristic curve (ROC) was drawn by MedCalc software, and the Hosmer-Lemeshow goodness of fit test was used to verify the difference between the prediction model and the actual observation results. Results　The age of onset of depression in the psychotic symptom group was lower than that in the non-psychotic symptom group [(27.11±3.94) years old vs. (31.19±4.01) years old]; the proportions of family history of depression, childhood abuse, depression accompanied by suicide tendency were higher than those in the non-psychotic symptom group [20.00% (13/65) vs. 6.73% (36/535), 41.54% (27/65) vs. 24.30% (130/535), 46.15% (30/65) vs. 29.35% (157/535)] (all P<0.05). Multivariate logistic regression analysis showed that family history of depression (OR: 2.483, 95%CI: 1.133-5.445), childhood abuse (OR: 2.234, 95%CI: 1.250-3.995), low age of onset of depression (OR: 0.794, 95%CI: 0.740-0.853), and depression with suicidal tendency (OR: 1.935, 95%CI: 1.093-3.428) were risk factors for psychotic symptoms in patients with depression (all P<0.05). ROC results showed that the area under the curve of the prediction model was 0.780 (95%CI: 0.744-0.812), the sensitivity was 80.00%, and the specificity was 64.11%. Conclusions　Depression patients with psychotic symptoms are closely related to family history of depression, childhood abuse, age of onset of depression, and depression with suicidal tendency. The predictive model is effective and can help medical staff identify psychotic symptoms early.

Key words:

Depression,  , Psychotic symptoms,  , Childhood abuse,  , Influencing factors, Prediction model