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轻度抑郁症:风险概况、功能残疾、医疗保健利用情况以及发展为重度抑郁症的风险。

Minor depression: risk profiles, functional disability, health care use and risk of developing major depression.

作者信息

Cuijpers Pim, de Graaf Ron, van Dorsselaer Saskia

机构信息

Netherlands Institute of Mental Health and Addiction (Trimbos Institute), P.O. Box 725, 3500 AS Utrecht, The Netherlands.

出版信息

J Affect Disord. 2004 Apr;79(1-3):71-9. doi: 10.1016/S0165-0327(02)00348-8.

DOI:10.1016/S0165-0327(02)00348-8
PMID:15023482
Abstract

BACKGROUND

minor depression has been found to affect quality of life, result in a increased service utilization, and lead to an increased risk of developing a major depression. In this study we examine risk profiles, functional disability, service utilization and the risk of developing major depression in minor depression.

METHODS

a random sample of the Dutch population (n=7076) was interviewed at baseline and 1 and 3 years later (response rate: 69.7%). Five categories of depression status were defined: major depression with seven to nine symptoms; with five or six symptoms; minor depression; one key symptom only; no depressive symptoms. Independent variables included: functional disability; care utilization; sociodemographic characteristics.

RESULTS

functional disability was more pronounced in more severe categories of depression. Health care use was also found to be most intensive for more severe depression. The risk of developing major depression in subjects with minor depression was found to be 8.0% after 2 years.

LIMITATIONS

there had already been some attrition from the study when minor depression was measured. A definition of minor depression which approached the DSM-IV definition. Absence of homeless individuals in the dataset.

CONCLUSIONS

depressive disorders seem to exist on a continuum, rather than in separate categories. Subjects with minor depression make less use of professional services than subjects with major depression, but because minor depression is more prevalent than major depression, the absolute number of subjects with minor depression receiving professional help is considerable.

摘要

背景

已发现轻度抑郁会影响生活质量,导致服务利用率增加,并增加发展为重度抑郁的风险。在本研究中,我们调查了轻度抑郁的风险概况、功能残疾、服务利用率以及发展为重度抑郁的风险。

方法

对荷兰人群的随机样本(n = 7076)在基线时、1年后和3年后进行访谈(应答率:69.7%)。定义了五类抑郁状态:有七至九个症状的重度抑郁;有五或六个症状的重度抑郁;轻度抑郁;仅有一个关键症状;无抑郁症状。自变量包括:功能残疾;医疗服务利用情况;社会人口学特征。

结果

功能残疾在更严重的抑郁类别中更为明显。还发现更严重的抑郁患者医疗服务使用最为频繁。轻度抑郁患者发展为重度抑郁的风险在2年后为8.0%。

局限性

在测量轻度抑郁时,研究中已经出现了一些人员流失。轻度抑郁的定义接近《精神疾病诊断与统计手册》第四版(DSM-IV)的定义。数据集中没有无家可归者。

结论

抑郁症似乎是一个连续体,而非分为不同类别。轻度抑郁患者比重度抑郁患者较少使用专业服务,但由于轻度抑郁比重度抑郁更为普遍,接受专业帮助的轻度抑郁患者的绝对数量相当可观。

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