Lewinsohn P M, Solomon A, Seeley J R, Zeiss A
Oregon Research Institute, Eugene 97403-1983, USA.
J Abnorm Psychol. 2000 May;109(2):345-51.
There is active debate regarding whether diagnosable depression exists on a continuum with subthreshold depressive symptoms or represents a categorically distinct phenomenon. To address this question, multiple indexes of dysfunction (psychosocial difficulties, mental health treatment history, and future incidence of major depression and substance abuse/dependence) were examined as a function of the extent of depressive symptoms in 3 large community samples (adolescent, adult, and older adult; N = 3,003). Increasing levels of depressive symptoms were associated with increasing levels of psychosocial dysfunction and incidence of major depression and substance use disorders. These findings suggest that (a) the clinical significance of depressive symptoms does not depend on crossing the major depressive diagnostic threshold and (b) depression may best be conceptualized as a continuum. Limitations of the present study are discussed.
关于可诊断的抑郁症是与阈下抑郁症状处于连续体上，还是代表一种截然不同的类别现象，目前存在着激烈的争论。为了解决这个问题，在3个大型社区样本（青少年、成年人和老年人；N = 3003）中，研究了多种功能障碍指标（心理社会困难、心理健康治疗史以及重度抑郁症和物质滥用/依赖的未来发病率）与抑郁症状程度的关系。抑郁症状水平的升高与心理社会功能障碍水平以及重度抑郁症和物质使用障碍的发病率增加相关。这些发现表明：（a）抑郁症状的临床意义并不取决于是否跨越重度抑郁诊断阈值；（b）抑郁症最好被概念化为一个连续体。本文讨论了本研究的局限性。
