Cuijpers Pim, Beekman Aartjan, Smit Filip, Deeg Dorly
Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.
Int J Geriatr Psychiatry. 2006 Sep;21(9):811-8. doi: 10.1002/gps.1565.
It is well-established that the incidence of major depressive disorder is increased in subjects with subthreshold depression. A new research area focuses on the possibilities of preventing the onset of major depressive disorders in subjects with subthreshold depression. An important research question for this research area is which subjects with subthreshold depression will develop a full-blown depressive disorder and which will not.
We selected 154 older subjects with subthreshold depression (CES-D>16) but no DSM mood disorder from a longitudinal study among a large population based cohort aged between 55 and 85 years in The Netherlands. Of these subjects, 31 (20.1%) developed a mood disorder (major depression and/or dysthymia) at three-year or six-year follow-up. We examined risk factors and individual symptoms of mood disorder as predictors of onset of mood disorder.
Two variables were found to be significant predictors in both bivariate and multivariate analyses: eating problems and sleep problems. The incidence of mood disorders differed strongly for different subpopulations, varying from 9% (for those not having any of the two risk factors) to 57% (for those having both risk factors).
It appears to be possible to predict to a certain degree whether a subject with subthreshold depression will develop a mood disorder during the following years.
阈下抑郁患者中重度抑郁症的发病率升高，这一点已得到充分证实。一个新的研究领域聚焦于预防阈下抑郁患者发生重度抑郁症的可能性。该研究领域的一个重要研究问题是，哪些阈下抑郁患者会发展为全面发作的抑郁症，哪些不会。
我们从荷兰一项针对55至85岁大量人群的纵向研究中，选取了154名阈下抑郁（CES-D>16）但无DSM心境障碍的老年受试者。在这些受试者中，31名（20.1%）在三年或六年随访时出现了心境障碍（重度抑郁症和/或恶劣心境）。我们检查了心境障碍的危险因素和个体症状，作为心境障碍发作的预测因素。
在双变量和多变量分析中，发现有两个变量是显著的预测因素：饮食问题和睡眠问题。不同亚组的心境障碍发病率差异很大，从9%（没有这两种危险因素的人）到57%（有两种危险因素的人）不等。
似乎有可能在一定程度上预测阈下抑郁患者在接下来几年是否会发展为心境障碍。
