Klier C M, Geller P A, Neugebauer R
Department of Psychiatry, University of Vienna, Austria.
J Affect Disord. 2000 Jul;59(1):13-21. doi: 10.1016/s0165-0327(99)00126-3.
Although minor depressive disorder is of considerable clinical and public health importance, it has received limited research attention relative to major depressive disorder. This study examines the incidence rate and relative risk for minor depressive disorder following miscarriage.
Using a cohort design we tested whether miscarrying women are at increased risk for an episode of minor depression (diagnosed based on research criteria proposed in Appendix B of DSM-IV) in the 6 months following loss. The miscarriage cohort consisted of women attending a medical center for spontaneous abortion (n=229); the comparison group was a population-based cohort of women drawn from the community (n=230).
Among miscarrying women, 5.2% experienced an episode of minor depression, compared with 1.0% of community women. The overall relative risk for an episode of minor depression for miscarrying women was 5.2 (95% confidence interval, 1.2-23.6). Relative risk did not vary by length of gestation at the time of loss or attitude toward the pregnancy. The majority of episodes in miscarrying women began within 1 month following loss.
Minor depression was relatively rare in both study cohorts. The resulting limits on statistical power reduced our ability to identify factors, such as sociodemographic or reproductive history variables that might moderate the effect of miscarriage on risk for minor depression.
These results, in the context of prior work showing increased risks of major depression and depressive symptoms following miscarriage, lend some support to the conceptualization of minor depressive disorder as part of a continuum of symptom severity. Miscarrying women should be evaluated for depression at their follow-up medical visits.
尽管轻度抑郁症具有相当大的临床和公共卫生重要性，但相对于重度抑郁症，它受到的研究关注有限。本研究考察了流产后轻度抑郁症的发病率和相对风险。
我们采用队列设计，检验流产女性在流产后6个月内发生轻度抑郁发作（根据《精神疾病诊断与统计手册》第四版附录B中提出的研究标准诊断）的风险是否增加。流产队列由在医疗中心进行自然流产的女性组成（n = 229）；对照组是从社区抽取的基于人群的女性队列（n = 230）。
在流产女性中，5.2%经历了轻度抑郁发作，而社区女性中这一比例为1.0%。流产女性发生轻度抑郁发作的总体相对风险为5.2（95%置信区间，1.2 - 23.6）。相对风险不因流产时的妊娠时长或对妊娠的态度而有所不同。流产女性中的大多数发作在流产后1个月内开始。
轻度抑郁在两个研究队列中都相对少见。由此导致的统计效能限制降低了我们识别可能调节流产对轻度抑郁风险影响的因素（如社会人口统计学或生殖史变量）的能力。
这些结果，结合先前显示流产后重度抑郁和抑郁症状风险增加的研究，为将轻度抑郁症概念化为症状严重程度连续体的一部分提供了一些支持。流产女性在后续的医疗随访中应接受抑郁症评估。
