Chen Cheng-Sheng, Chong Mian-Yoon, Tsang Hin-Yeung
Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int J Geriatr Psychiatry. 2007 Jun;22(6):557-62. doi: 10.1002/gps.1714.
The aim of this study was to investigate the 1-month prevalence, symptom profiles and demographic correlates in late-life clinically significant non-major depression (CSNMD) among a community-dwelling elderly population.
One thousand five hundred subjects aged 65 years and older, who were randomly selected from three communities in Taiwan, received comprehensive psychiatric assessment by trained psychiatrists. Two categorical diagnoses of depressive disorder, including major depression and CSNMD, were made. The 1-month prevalence was calculated. Frequencies of depressive symptoms across CSNMD and major depression were compared. The risks of CSNMD based on demographic characteristics were estimated using multinominal logistic regression.
The 1-month prevalence of CSNMD among the community-dwelling elderly was 8.8%. Symptoms of diminished interest, appetite changes, sleep disturbance, worthlessness or inappropriate guilt, trouble in concentrating or indecisiveness, and suicidal thoughts or acts were less frequent in CSNMD than in major depression, but symptoms of depressed mood, psychomotor changes, and fatigue or loss of energy were as frequent in both categories of illness. CSNMD shares similar demographic risks, such as living in an urban area, female gender and low educational status, with major depression.
CSNMD is common among community-dwelling elders in Taiwan, and with its identical demographic characteristics, but qualitatively different presentation, we suggest CSNMD may be considered part of a spectrum of severe late life depressions with a distinct manifestation. Major depression and CSNMD may share common demographic characteristics with different manifestation. We conclude that late-life depression is a dimensional disease.
本研究旨在调查社区居住老年人群中晚期具有临床意义的非重度抑郁症（CSNMD）的1个月患病率、症状特征及人口统计学相关性。
从台湾三个社区随机选取1500名65岁及以上的受试者，由训练有素的精神科医生进行全面的精神评估。做出了两种抑郁障碍的分类诊断，包括重度抑郁症和CSNMD。计算1个月患病率。比较了CSNMD和重度抑郁症中抑郁症状的频率。使用多项逻辑回归估计基于人口统计学特征的CSNMD风险。
社区居住老年人中CSNMD的1个月患病率为8.8%。与重度抑郁症相比，CSNMD中兴趣减退、食欲改变、睡眠障碍、无价值感或不适当的内疚感、注意力不集中或犹豫不决以及自杀念头或行为等症状出现的频率较低，但情绪低落、精神运动改变以及疲劳或精力丧失等症状在这两类疾病中出现的频率相同。CSNMD与重度抑郁症具有相似的人口统计学风险，如居住在城市地区、女性性别和低教育水平。
CSNMD在台湾社区居住的老年人中很常见，因其人口统计学特征相同，但表现形式在性质上不同，我们建议CSNMD可被视为具有独特表现的重度晚期抑郁症谱系的一部分。重度抑郁症和CSNMD可能具有相同的人口统计学特征，但表现形式不同。我们得出结论，晚期抑郁症是一种维度性疾病。
