Kaptein Kirsten I, De Jonge Peter, Korf Jakob, Spijker Jan, De Graaf Ron, Van Der Werf Siebren Y
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands.
Psychol Med. 2007 Sep;37(9):1261-71. doi: 10.1017/S0033291707001018. Epub 2007 Jul 5.
It has recently been proposed that major depression disorder (MDD) may, in a heterogeneous population-based cohort, be interpreted in terms of a random-mood model. Mood fluctuations are thought to result from stressors that occur randomly in time. We have investigated whether this concept also holds for more homogeneous groups, defined by known determinants for MDD, and whether the model's parameters, susceptibility (Z) and relaxation time (T), may be evaluated and used to differentiate between subcohorts.
From a large epidemiological survey, the Netherlands Mental Health Survey and Incidence Study (NEMESIS), data on the duration of MDD were obtained for subcohorts, based on gender, severity of depression, recurrence and co-morbidity with dysthymia, anxiety and somatic disorder, and were compared with random-mood simulation calculations.
Susceptibility, Z, is empirically found to be proportional to incidence and may be identified with a risk ratio. A second scaling rule states the proportionality of mean duration with the product of Z and T. This Z-T classification proves to be more sensitive than conventional significance tests. Notably for men/women and for co-morbid anxiety, differences are seen that have previously gone unnoticed.
Depression may be conceptualized as a disorder resulting from random-mood fluctuations, the response to which is influenced by a large variety of determinants or risk factors. The model's parameters can be evaluated and may be used in differentiating between risk factor-defined subgroups.
最近有人提出，在一个基于人群的异质性队列中，重度抑郁症（MDD）可能可以用随机情绪模型来解释。情绪波动被认为是由随时间随机出现的压力源导致的。我们研究了这个概念对于由MDD的已知决定因素定义的更同质群体是否也成立，以及该模型的参数，即易感性（Z）和弛豫时间（T），是否可以评估并用于区分亚队列。
从一项大型流行病学调查——荷兰心理健康调查与发病率研究（NEMESIS）中，获取了基于性别、抑郁严重程度、复发情况以及与心境恶劣、焦虑和躯体疾病共病情况的亚队列的MDD持续时间数据，并与随机情绪模拟计算结果进行了比较。
通过实证发现，易感性Z与发病率成正比，并且可以用风险比来确定。第二条缩放规则表明平均持续时间与Z和T的乘积成正比。这种Z - T分类被证明比传统的显著性检验更敏感。值得注意的是，在男性/女性以及共病焦虑方面，发现了以前未被注意到的差异。
抑郁症可以被概念化为一种由随机情绪波动导致的疾病，对其的反应受到多种决定因素或风险因素的影响。该模型的参数可以评估，并且可用于区分由风险因素定义的亚组。
