Horowitz Amy, Reinhardt Joann P, Kennedy Gary J
Arlene R. Gordon Research Institute, Lighthouse International, 111 East 59th St., New York, NY 10022, USA.
Am J Geriatr Psychiatry. 2005 Mar;13(3):180-7. doi: 10.1176/appi.ajgp.13.3.180.
Authors examined the potential risk factors of major and subthreshold depression among elderly persons seeking rehabilitation for age-related vision impairment.
Participants (N=584), age 65 and older, with a recent vision loss, were new applicants for rehabilitation services. Subthreshold depression was defined as a depressive syndrome not meeting criteria for a current major depression (i.e., minor depression, major depression in partial remission, dysthymia) or significant depressive symptomatology.
Seven percent of respondents had a current major depression, and 26.9% met the criteria for a subthreshold depression. Poorer self-rated health, lower perceived adequacy of social support, decreased feelings of self-efficacy, and a past history of depression increased the odds of both a subthreshold and major depression, versus no depression, but greater functional disability and experiencing a negative life event were significant only for a subthreshold depression. Only a history of past depression was significant in increasing the odds of having a major versus a subthreshold depression.
Results highlight similarities in characteristics of, and risk factors for, subthreshold and major depression. Future research is needed to better understand both the trajectory and treatment of subthreshold depression, relative to major depressive disorders.
作者研究了因年龄相关性视力损害而寻求康复治疗的老年人中重度和阈下抑郁症的潜在危险因素。
参与者（N = 584）年龄在65岁及以上，近期有视力丧失，是康复服务的新申请者。阈下抑郁症被定义为不符合当前重度抑郁症标准的抑郁综合征（即轻度抑郁症、部分缓解的重度抑郁症、心境恶劣）或明显的抑郁症状。
7%的受访者目前患有重度抑郁症，26.9%符合阈下抑郁症的标准。自我评定健康状况较差、感知到的社会支持充足度较低、自我效能感降低以及有抑郁症病史，与无抑郁症相比，会增加阈下抑郁症和重度抑郁症的患病几率，但功能残疾程度较高和经历负面生活事件仅对阈下抑郁症有显著影响。只有过去的抑郁症病史在增加重度抑郁症与阈下抑郁症患病几率方面具有显著意义。
结果突出了阈下抑郁症和重度抑郁症在特征及危险因素方面的相似性。需要进一步研究以更好地了解相对于重度抑郁症而言阈下抑郁症的病程及治疗方法。
