Montgomery S A, Montgomery D B, Bulloch T
Department of Psychiatry, St Mary's Hospital, London, UK.
Encephale. 1992 Jan;18 Spec No 1:41-3.
Recurrent brief depression is now recognised separately in the international classification of diseases (ICD 10). The disorder is characterised by short severe bouts of depression which recur frequently but erratically. In our series of patients the median duration of the depression is 3 days, with two thirds lasting between 2 and 4 days. The severity is often marked with a mean MADRS score of 30, and the episodes recurred 20 times a year. The disorder is easily separated from major depression which lasts 2 weeks or more, although, there is an unfortunate overlap group with major depression superimposed on the recurrent brief pattern. Those with "combined depression" have a higher suicide attempt rate. There should be little overlap with dysthymia since on average only 20% of the time is spent depressed, whereas dysthymia requires a minimum of 50%. However, in practice the qualification of the time spent depressed is imprecise in dysthymia so there is potential for misdiagnosis. There is little overlap with bipolar illness. In our series with follow up of up to 15 years, the conversion rate to bipolar illness is low at 3%. Almost all of these were found to have combined depression, which suggests that the rate for pure recurrent brief depression is very low. These data suggest that pure recurrent brief depression is a unipolar depressive illness.
复发性短暂抑郁症目前在《国际疾病分类》（ICD - 10）中被单独列出。该疾病的特征是短时间内严重的抑郁发作，发作频繁但无规律。在我们的患者系列中，抑郁的中位持续时间为3天，三分之二的发作持续2至4天。严重程度通常较为显著，平均蒙哥马利 - 艾森伯格抑郁量表（MADRS）评分为30分，且发作每年复发20次。该疾病很容易与持续两周或更长时间的重度抑郁症区分开来，不过，存在一个不幸的重叠群体，即重度抑郁症叠加在复发性短暂模式之上。患有“合并性抑郁症”的人自杀未遂率更高。与恶劣心境的重叠应该很少，因为平均而言只有20%的时间处于抑郁状态，而恶劣心境至少需要50%的时间。然而，在实践中，恶劣心境中抑郁时间的界定并不精确，因此存在误诊的可能性。与双相情感障碍的重叠也很少。在我们长达15年随访的系列研究中，转变为双相情感障碍的转化率很低，为3%。几乎所有这些病例都被发现患有合并性抑郁症，这表明纯复发性短暂抑郁症的发生率非常低。这些数据表明，纯复发性短暂抑郁症是一种单相抑郁性疾病。
