Risk factors of psychotic symptoms in young patients with first-episode depressive disorder
Objective To explore the risk factors of secondary psychotic symptoms in first episode of major depression disorder(MDD)in young adults.Methods General demographic data,Hamilton depression scale(HAMD-17)and Hamilton anxiety scale(HAMA)scores of 232 patients with first-episode depression were collected at the first diagnosis.Cubital venous blood was collected to measure blood glucose,lipids,thyroid function,prolactin and 25-hydroxyvitamin D[25(OH)D]in next day.After one year of follow-up,the MDD patients were divided into psychotic symptom group(PMD group,n=46)and non-psychotic symptom group(MDD group,n=186).The differences of clinical indexes between two groups were compared,the correlation between each index and psychotic symptoms was analyzed,and the risk factors associated with PMD in young patients were explored.Results The proportion of unmarried patients in PMD group was higher than that in MDD group(P＜0.05).The score of HAMD-17 in PMD group was higher than that in MDD group(P＜0.05).The levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and thyroid stimulating hormone(TSH)in PMD group were higher than those in MDD group,but the levels of high density lipoprotein cholesterol(HDL-C)and 25(OH)D in PMD group were lower than those in MDD group(P＜0.05).Correlation analysis showed that HAMD-17 score(r=0.345),TC(r=0.148),LDL-C(r=0.162)and TSH level(r=0.134)were positively correlated with psychotic symptoms(P＜0.05).Married(r=-0.208),HDL-C(r=-0.258)and25(OH)D level(r=-0.276)were negatively correlated with psychotic symptoms(P＜0.05).Multivariate Logistic regression analysis showed that unmarried,HAMD-17 scale score,higher TC,lower HDL-C and lower 25(OH)D level were in-dependent risk factors for psychotic symptoms in MDD patients(P＜0.05).The ROC curve suggested that the combined index based on marital status,HAMD-17 score,serum TC,HDL-C and 25(OH)D levels better predicted the occurrence of psychotic symptoms in MDD patients(AUC=0.887).Conclusion Serum lipid metabolism and 25(OH)D levels may be the biomarkers for predicting secondary psychotic symptoms in young MDD patients.
major depressive disorderpsychotic symptomstotal cholesterolhigh density lipoprotein cholesterol25-hydroxyvitamin Drisk factors
万方数据
维普
