Geerlings S W, Beekman A T, Deeg D J, Van Tilburg W
Department of Psychiatry, Free University Amsterdam and Institute for Research in Extramural Medicine (EMGO), The Netherlands.
Psychol Med. 2000 Mar;30(2):369-80. doi: 10.1017/s0033291799001890.
Poor physical health has long been recognized to be one of the most important risk factors for depression in older adults. Since many aspects of physical health can be targeted for improvement in primary care, it is important to know whether physical health problems predict the onset and/or the persistence of depression.
The study is based on a sample which at the outset consisted of 327 depressed and 325 non-depressed older adults (55-85) drawn from a larger random community-based sample in the Netherlands. Depression was measured using the Center for Epidemiologic Studies Depression scale (CES-D) at eight successive waves.
From all incident episodes, the majority (57%) was short-lived. These short episodes could generally not be predicted by physical health problems. The remaining incident episodes (43%) were not short-lived and could be predicted by poor physical health. Chronicity (34%) was also predicted by physical health problems.
The study design with its frequent measurements recognized more incident cases than previous studies; these cases however did have a better prognosis than is often assumed. The prognosis of prevalent cases was rather poor. Physical health problems were demonstrated to be a predictor of both the onset and the persistence of depression. This may well have implications for prevention and intervention.
长期以来，身体健康状况不佳一直被认为是老年人患抑郁症最重要的风险因素之一。由于身体健康的许多方面都可以在初级保健中得到改善，了解身体健康问题是否能预测抑郁症的发作和/或持续存在就显得很重要。
该研究基于一个样本，最初包括从荷兰一个更大的基于社区的随机样本中抽取的327名抑郁和325名非抑郁的老年人（55 - 85岁）。在连续八次随访中使用流行病学研究中心抑郁量表（CES - D）测量抑郁情况。
在所有新发发作中，大多数（57%）是短暂的。这些短暂发作通常无法通过身体健康问题预测。其余新发发作（43%）不是短暂的，可以通过身体健康状况不佳预测。慢性病（34%）也可通过身体健康问题预测。
该研究设计因其频繁测量比以往研究识别出更多新发病例；然而，这些病例的预后比通常认为的要好。现患病例的预后相当差。身体健康问题被证明是抑郁症发作和持续存在的一个预测因素。这很可能对预防和干预有影响。
