Drieling Tobias, van Calker Dietrich, Hecht Heidemarie
Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany.
J Affect Disord. 2006 Apr;91(2-3):195-203. doi: 10.1016/j.jad.2006.01.004. Epub 2006 Feb 20.
The aim of the study was to identify risk factors in subjects at risk for depressive disorders and controls.
In a 6.5 year follow-up study we examined the effects of personality (neuroticism, frustration intolerance, rigidity, melancholic type), adverse life events and chronic difficulties on depressive symptoms in 89 high-risk subjects (HRS, siblings and children of patients suffering from an affective disorder), without any mental illness at wave 1 (T1), and 49 controls without any personal and family history of psychiatric disorder at T1. To this end, regression analysis and path analysis using a structural equation model (only for HRS) were performed.
Risk factors for depressive symptoms at wave 2 (T2) in HRS comprised acute adverse life events, frustration intolerance (T1) and depressive symptoms (T1). Risk factors for depressive symptoms in controls included chronic difficulties, neuroticism and rigidity. HRS had less stressful life events and the same risk for chronic difficulties, but perceived adverse events as more stressful.
The sample size of the control group is too small for identifying slight effects.
Our results indicate that the impact on the emergence of depressive symptoms of various risk factors is different in high-risk subjects and controls. High-risk subjects are more sensitive to the depressogenic effects of acute stress and thus avoid potential stressful changes in their life to a higher extent. On the other hand, the influence of persistent factors such as personality traits (neuroticism, rigidity) and chronic difficulties on subsequent depressive symptoms was less pronounced in HRS as compared to controls.
本研究旨在确定抑郁症高危人群和对照组中的风险因素。
在一项为期6.5年的随访研究中，我们考察了人格特质（神经质、挫折不耐受、僵化、抑郁型人格）、不良生活事件和长期困难对89名高危受试者（HRS，情感障碍患者的兄弟姐妹和子女）抑郁症状的影响，这些受试者在第1波（T1）时无任何精神疾病，以及49名在T1时无任何个人和家族精神病史的对照组。为此，进行了回归分析和使用结构方程模型的路径分析（仅针对HRS）。
HRS中第2波（T2）抑郁症状的风险因素包括急性不良生活事件、挫折不耐受（T1）和抑郁症状（T1）。对照组抑郁症状的风险因素包括长期困难、神经质和僵化。HRS的生活压力事件较少，长期困难的风险相同，但将不良事件视为压力更大。
对照组样本量过小，无法识别微小影响。
我们的结果表明，各种风险因素对抑郁症状出现的影响在高危受试者和对照组中有所不同。高危受试者对急性应激的致抑郁作用更敏感，因此在更大程度上避免生活中潜在的压力变化。另一方面，与对照组相比，人格特质（神经质、僵化）和长期困难等持续性因素对HRS后续抑郁症状的影响不太明显。
