摘要目的 探讨抑郁症患者自主性动机的特点及其对抑郁症状严重程度和短期疗效的影响.方法 采用行为趋近和抑制系统量表(BAS/BIS),动机特征问卷简版(MTQ),汉密尔顿抑郁量表(HAMD-17)与汉密尔顿焦虑量表(HAMA)对82例住院抑郁症患者分别在基线及治疗2周后以及性别年龄匹配的82例健康对照进行评估,以HAMD总分在治疗前后的减分率作为主要疗效指标.结果 抑郁症患者在MTQ-求知因子分[(30.37±6.78)分]、MTQ-精通因子分[(28.68±6.24)分]、BAS-驱力因子分[(9.90±2.76)分]显著低于健康对照组分别为[(33.72±4.34)分,(32.29±4.74)分,(11.18± 2.13)分],差异有统计学意义(均P<0.01);而MTQ-情绪化因子分[(36.26±7.14)分]、MTQ-担心因子分[(40.87±7.56)分]、BIS因子分[(22.68±2.61)分]均显著高于健康对照组分别为[(27.29±5.73)分,(33.69±6.38)分,(15.51±3.62)分],差异有统计学意义(均P<0.01).相关性分析发现,患者基线HAMD-17总分与基线HAMA总分(r=0.666,P<0.05)、BIS(r=0.278,P<0.05)、MTQ-担心(r=0.264,P<0.05)、MTQ-情绪化(r=0.371,P<0.05)呈显著正相关;基线 HAMA总分与基线 HAMD-17总分(r=0.666,P<0.05)、MTQ-担心(r=0.228,P<0.05)、MTQ-情绪化(r=0.282,P<0.05)呈显著正相关.对患者治疗2周的HAMD-17和HAMA减分率分别进行逐步回归分析发现MTQ-精通、BAS-驱力的贡献显著,解释HAMD-17减分率变异的19%(R2=0.19);BAS-驱力的贡献显著,解释HAMA减分率变异的16.9%(R2=0.169).结论 抑郁症患者自主性动机水平显著低于健康对照,较高的自主性动机水平(BAS-驱力)可能与较好的临床疗效相关.

abstractsObjective To investigate the traits of autonomous motivation and its effect on the de-pression severity and short-term clinic outcome. Methods Behavioral Approach System and Behavioral In-hibition System Scale(BAS / BIS),Motivational Traits Questionnaire Short Form(MTQ),the Hamilton De-pression Scale(HAMD-17)and the Hamilton Anxiety Scale(HAMA)were applied to 82 depression patients (case group)at baseline and after 2 weeks of treatment and 82 gender-matched healthy controls(control group). The reduction rate of HAMD total scores before and after treatment was used as the main efficacy in-dicator.Results The scores of MTQ-desire to learn((30.37 ± 6.78)vs(33.72 ± 4.34))and MTQ-mastery ((28.68±6.24)vs(32.29±4.74)),BAS-drive scores((9.90±2.76)vs(11.18±2.13))were significantly lower in the case group than those in the control group,and the difference was statistically significant(all P<0.001),While the scores of MTQ-emotionality((36.26± 7.14)vs(27.29± 5.73)),MTQ-worry((40.87± 7.56)vs(33.69±6.38)),BIS scores((22.68±2.61)vs(15.51±3.62))were significantly higher than those in the control group,the difference was statistically significant(all P<0.01).Correlation analysis found that baseline HAMD-17total scores were significantly positively correlated with baseline HAMA total scores(r=0.666,P<0.05),BIS(r=0.278,P<0.05),MTQ-worry(r=0.264,P<0.05)and MTQ- emotionality(r=0.371, P<0.05). Baseline HAMA total scores were significantly positively correlated with baseline HAMD-17 total scores(r=0.666,P<0.05),MTQ-worry(r=0.228,P<0.05)and MTQ-emotionality(r=0.282,P<0.05). The reduction rate of HAMD-17 and HAMA in patients with 2 weeks of treatment was respectively used with step-wise regression analysis,which showed that the significant contribution of MTQ-mastery and BAS-drive,and explained the reduction rate variables 19%(R2=0.19)of HAMD. BAS-drive contributed significantly,and explained the reduction rate variables 16.9%(R2=0.169)of HAMA. Conclusion Autonomous motivation levels of depression patients are significantly lower than that of healthy controls,while higher levels of autono-mous motivation(BAS-drive)may be associated with better short-term clinic outcome.