Klein Daniel N, Shankman Stewart A, Lewinsohn Peter M, Rohde Paul, Seeley John R
Department of Psychology, Stony Brook University, NY 11794-2500, USA.
Am J Psychiatry. 2004 Apr;161(4):646-53. doi: 10.1176/appi.ajp.161.4.646.
The validity of the distinctions between dysthymic disorder, chronic major depressive disorder, and episodic major depressive disorder was examined in a family study of a large community sample of young adults.
First-degree relatives (N=2,615) of 30 probands with dysthymic disorder, 65 probands with chronic major depressive disorder, 313 probands with episodic major depressive disorder, and 392 probands with no history of mood disorder were assessed by using direct interviews and informant reports.
The rates of major depressive disorder were significantly greater among the relatives of probands with dysthymic disorder and chronic major depressive disorder than among the relatives of probands with episodic major depressive disorder, who in turn exhibited a higher rate of major depressive disorder than the relatives of probands with no history of mood disorder. The relatives of probands with dysthymic disorder had a significantly higher rate of dysthymic disorder than the relatives of probands with no history of mood disorder, and the relatives of probands with chronic major depressive disorder had a significantly higher rate of chronic major depressive disorder than the relatives of probands with no history of mood disorder. However, the relatives of the three groups of probands with depression did not differ on rates of dysthymic disorder and chronic major depressive disorder.
Chronic depression is distinguished from episodic depression by a more severe familial liability. This familial liability may contribute to the more pernicious course of chronic depression.
在一项针对大量年轻成年人社区样本的家族研究中，检验恶劣心境障碍、慢性重度抑郁症和发作性重度抑郁症之间区分的有效性。
通过直接访谈和知情者报告，对30名患有恶劣心境障碍的先证者、65名患有慢性重度抑郁症的先证者、313名患有发作性重度抑郁症的先证者以及392名无心境障碍病史的先证者的一级亲属（N = 2615）进行评估。
患有恶劣心境障碍和慢性重度抑郁症的先证者亲属中，重度抑郁症的发病率显著高于患有发作性重度抑郁症的先证者亲属，而后者又比无心境障碍病史的先证者亲属表现出更高的重度抑郁症发病率。患有恶劣心境障碍的先证者亲属中，恶劣心境障碍的发病率显著高于无心境障碍病史的先证者亲属，患有慢性重度抑郁症的先证者亲属中，慢性重度抑郁症的发病率显著高于无心境障碍病史的先证者亲属。然而，三组患有抑郁症的先证者亲属在恶劣心境障碍和慢性重度抑郁症的发病率上并无差异。
慢性抑郁症与发作性抑郁症的区别在于更严重的家族易感性。这种家族易感性可能导致慢性抑郁症病程更具危害性。
