A Retrospective Analysis Of Clinical Features,Efficacy And Adverse Reactions In Elderly Hospitalized Patients With Depression

Objective:The clinical characteristics,current common clinical treatment regimens and their efficacy and adverse reactions of hospitalized patients with Late-Life Depression(LLD)were analyzed,in order to promote the prevention,improve the efficacy and reduce the occurrence of adverse reactions in elderly depression.Method:The subjects of the study were elderly depression patients hospitalized in Qingdao Mental Health Center from January 2019 to December 2020.Their basic information was collected using a self-made basic demographic characteristics questionnaire.Collect medication regimens through medical order records,first divide them into four groups to analyze the efficacy of different medication regimens,and then further divide antidepressants into five groups to analyze the efficacy of different synergistic treatments.Use the Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Scale(HAMA)to assess the patient’s depression and anxiety status before and after treatment,After 8 weeks of treatment,the efficacy of patients was evaluated based on the decline rate of HAMD scores.(Recovery: score reduction rate≥ 75%;significant effect: score reduction rate between 50% and 74%;effective: score reduction rate between 30% and 49%;ineffective: score reduction rate ≤ 29%.)The incidence of adverse reactions in the patient was evaluated by treatment emergency symptom scale(TESS),course records,laboratory results,etc.Result:1.There are significantly more female patients with depression than males,with228 males and 631 females,with a male to female ratio of 1:2.77.2.Elderly depression patients often have triggers for onset,with negative life events being the most common,and fatigue and anger are also common triggers.Fewer patients(135 cases,15.72%)experienced psychiatric symptoms,while the vast majority of patients(797 cases,92.78%)experienced significant somatization symptoms.782 patients(91.04%)were all treated with antidepressants combined with other psychiatric medications.3.Comparison of HAMD reduction and reduction rate: Compared with 8 weeks after treatment,there were statistically significant differences in HAMD reduction and reduction rate among the four medication groups before treatment.HAMD reduction H=30.199,P<0.001,HAMD reduction H=35.840,P<0.001,and the combination of antidepressants and other medication groups had higher reduction and reduction rates than the single antidepressant group and the non antidepressant group.Comparison of HAMA reduction and reduction rate: Compared with 8 weeks of treatment before and after treatment,there were statistically significant differences in HAMA reduction and reduction rate among the four medication groups.HAMA reduction H=15.904,P=0.001,HAMA reduction rate H=29.289,P<0.001,HAMA reduction in combination with other drugs was higher than that in the single antidepressant group,The reduction rate of antidepressants in combination with other drugs was higher than that in the single antidepressant group and the combination of two or more antidepressants group.4.After 8 weeks of treatment,there was a statistically significant difference in the recovery rate and effective rate among the four medication groups(recovery rate χ 2value=31.080,P<0.001;Efficiency χ 2 values=48.767,P=<0.001),indicating that the combination of antidepressants and other drugs group was higher than the single use of antidepressants and the non use of antidepressants group.5.Comparison of synergistic treatment: There was a difference in the HAMD score reduction rate between the synergistic treatment group using mood stabilizer and the synergistic treatment group using sedative hypnotic,H=-211.391,P=0.016,and their quartile were [85.19(55.43100.00)] and [50.00(33.33,75.78)],respectively.The score reduction rate of the synergistic treatment group using mood stabilizer was higher than that of the synergistic treatment group using sedative hypnotic.The efficacy of using two or more drugs for synergistic treatment was not superior to using any one of the drugs for synergistic treatment group(P>0.05).6.Comparison of adverse reactions: There was a statistically significant difference in the incidence of adverse reactions among the four groups,χ 2value=8.996,P=0.027.The incidence of adverse reactions in the group of antidepressants combined with other drugs(37.72%)was higher than that in the group of antidepressants alone(17.24%),χ 2 value=5.033,P value<0.05.Conclusion:1.Elderly depression patients are significantly more female than male.2.Most patients have triggers for the onset of the disease,mainly negative life events.There are fewer cases of psychotic symptoms,and the vast majority of patients experience physical symptoms.Among common symptoms,poor sleep and diet are most commonly reported by family members,but decreased attention and low self-evaluation are less commonly reported.3.Elderly depression is often treated with antidepressants combined with other psychiatric drugs.In terms of reducing HAMD and HAMA scores,the combination of antidepressants and other drugs showed better efficacy than the other three groups.4.When only one drug is used for synergistic treatment of depression,sedative hypnotic are used most and mood stabilizers are used least in clinical practice,but the HAMD reduction rate of mood stabilizers group is higher than that of sedative hypnotic group.The use of two or more drugs as synergistic treatment is not superior to the use of any one of the drugs as synergistic treatment group.5.The combination of antidepressants and other drugs showed better efficacy than the other three groups,but the adverse reactions also increased.