Wilhelm K, Parker G, Dewhurst-Savellis J, Asghari A
School of Psychiatry, University of New South Wales, Sydney, Australia.
J Affect Disord. 1999 Jul;54(1-2):139-47. doi: 10.1016/s0165-0327(98)00170-0.
To examine for differential psychological risk factors in a nonclinical sample having single or recurrent episodes of major depression.
A cohort of 164 subjects was assessed initially in 1978 in their last year of teacher training, and at five-yearly intervals in 1983, 1988 and 1993. Experience of episodes of DSM major depression and anxiety disorders from each wave were summed and three groups (nil, one, and two or more episodes of major depression) were derived. The cohort also completed a series of self-report measures including neuroticism, state and trait depression, self-esteem, dependency, childhood parental environment and social support.
The group with two or more episodes were distinctly more likely to have met lifetime criteria for an anxiety disorder and to have had multiple anxiety disorder diagnoses over their lifetime. Groups with one or more episodes reported higher mean scores for trait depression, neuroticism and maternal overprotection and lower mean scores for paternal care and self esteem at baseline in 1978, but these variables did not predict differences between groups with single and recurrent episodes. At 1993, those with two or more episodes differed from those with none and single episodes in reporting lower trait depression scores and decreased perception of satisfactory social support over time, suggesting a psychological scarring effect for those with repeated episodes.
研究在患有单次或复发性重度抑郁症的非临床样本中是否存在不同的心理风险因素。
1978年，对164名受试者在其教师培训的最后一年进行了初步评估，并于1983年、1988年和1993年每隔五年进行一次评估。汇总每次评估中DSM重度抑郁症和焦虑症发作的经历，并分为三组（无、单次、两次或更多次重度抑郁症发作）。该队列还完成了一系列自我报告测量，包括神经质、状态和特质抑郁、自尊、依赖、童年父母环境和社会支持。
有两次或更多次发作的组明显更有可能符合焦虑症的终生标准，并且一生中多次被诊断为焦虑症。有一次或更多次发作的组在1978年基线时报告的特质抑郁、神经质和母亲过度保护的平均得分较高，而父亲关怀和自尊的平均得分较低，但这些变量并不能预测单次发作组和复发性发作组之间的差异。在1993年，有两次或更多次发作的组与无发作组和单次发作组不同，他们报告的特质抑郁得分较低，并且随着时间的推移对满意社会支持的感知下降，这表明复发性发作的人存在心理创伤效应。
