Lyness Jeffrey M, Niculescu Aurelian, Tu Xin, Reynolds Charles F, Caine Eric D
Program in Geriatrics and Neuropsychiatry, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642, USA.
Psychosomatics. 2006 Sep-Oct;47(5):435-9. doi: 10.1176/appi.psy.47.5.435.
Comorbid medical illnesses are a key feature of geriatric mood disorders, yet the specificity of such associations remains unclear. In a sample of 546 primary care patients age >or=65 years, pathology in several organ systems (respiratory, eye/ear/nose/throat, gastrointestinal, central nervous system, endocrine) and several chronic conditions (neurological disease, low vision, chronic obstructive pulmonary disease, diabetes) were associated with depression. However, notwithstanding these specific associations, global (overall) medical burden was most powerfully and independently associated with depression, largely independent of functional status. This generates the hypothesis that, in general primary care populations, the relationship of medical illness to depression may be multimodal and/or may involve shared pathobiological or psychosocial mechanisms.
共病性躯体疾病是老年期情绪障碍的一个关键特征，然而此类关联的特异性仍不明确。在一个由546名年龄≥65岁的初级保健患者组成的样本中，多个器官系统（呼吸、眼/耳/鼻/喉、胃肠道、中枢神经系统、内分泌）的病变以及多种慢性疾病（神经疾病、视力低下、慢性阻塞性肺疾病、糖尿病）与抑郁相关。然而，尽管存在这些特定关联，但总体（整体）医疗负担与抑郁的关联最为强烈且独立，很大程度上独立于功能状态。这就产生了一个假设，即在一般初级保健人群中，躯体疾病与抑郁的关系可能是多模式的和/或可能涉及共同的病理生物学或心理社会机制。
