Gilmer W S, Trivedi M H, Rush A J, Wisniewski S R, Luther J, Howland R H, Yohanna D, Khan A, Alpert J
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Acta Psychiatr Scand. 2005 Dec;112(6):425-33. doi: 10.1111/j.1600-0447.2005.00633.x.
To identify baseline sociodemographic and clinical factors associated with a current chronic major depressive episode (MDE).
Outpatients with major depressive disorder enrolled in 41 US primary or psychiatric care sites were divided into two groups based on self-report of current episode length (<24 or > or =24 months). Logistic regression models were used to identify factors associated with chronicity of current depressive episode.
About 21.2% of 1380 subjects were in current, chronic MDEs. Older age, less education, lower income, no private insurance, unemployment, greater general medical illness burden, lower physical quality of life, concurrent generalized anxiety disorder, fewer prior episodes, and history of prior suicide attempts were all associated with chronic episodes. Blacks, Hispanics, and patients receiving care in primary as opposed to psychiatric care settings exhibited greater chronicity.
Chronic depressive episodes are common and are associated with greater illness burden, comorbidity, socioeconomic disadvantage, and racial/ethnic minority status.
确定与当前慢性重度抑郁发作（MDE）相关的基线社会人口统计学和临床因素。
在美国41个初级或精神科护理机构登记的重度抑郁症门诊患者，根据当前发作时长的自我报告（<24个月或≥24个月）分为两组。采用逻辑回归模型确定与当前抑郁发作慢性化相关的因素。
1380名受试者中约21.2%处于当前慢性MDE状态。年龄较大、受教育程度较低、收入较低、无私人保险、失业、总体医疗疾病负担较重、身体生活质量较低、并发广泛性焦虑症、既往发作次数较少以及既往有自杀未遂史均与慢性发作相关。黑人、西班牙裔以及在初级而非精神科护理机构接受治疗的患者表现出更高的慢性化程度。
慢性抑郁发作很常见，且与更大的疾病负担、合并症、社会经济劣势以及种族/族裔少数群体身份相关。
