Beard John R, Tracy Melissa, Vlahov David, Galea Sandro
Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York City, NY, USA.
Ann Epidemiol. 2008 Mar;18(3):235-43. doi: 10.1016/j.annepidem.2007.10.004.
Past research has demonstrated the high prevalence of depression in the general population. However, few longitudinal studies have characterized the patterns of depression in a large, representative sample of the general population. We monitored symptoms of depression and assessed the factors associated with changing symptoms of depression in a population-based cohort over a 30 month period.
Using telephone surveys, we recruited 2752 adult residents of New York City in 2002. Persons were re-contacted after baseline for telephone interviews at 6 months, 18 months, and 30 months.
Among study participants, symptoms of depression were common, often resolved within 6 months, but tended to recur. Participants with a past history of depressive symptoms were more at risk of later developing depression, even if they were asymptomatic at baseline. Factors significantly associated with subsequent symptoms included less social support at baseline, income below a threshold of $50,000, life stressors, poor health, and being separated. Lower levels of social support and lifetime stressors were only significantly associated with symptoms in participants with multiple episodes of depression. The influence of recent stressful events was also higher among participants with multiple episodes of depression.
In the general population depression has a good immediate prognosis but a recurring nature. Poor physical health and low levels of social support appear to increase the risk of later episodes of depression. The influence of social risk factors may be greater for persons with higher susceptibility to depression.
过去的研究表明抑郁症在普通人群中普遍存在。然而，很少有纵向研究对普通人群中具有代表性的大样本的抑郁症模式进行描述。我们在30个月的时间里监测了一个基于人群的队列中抑郁症的症状，并评估了与抑郁症症状变化相关的因素。
2002年，我们通过电话调查招募了2752名纽约市成年居民。在基线调查后，分别在6个月、18个月和30个月对这些人进行电话随访。
在研究参与者中，抑郁症症状很常见，通常在6个月内缓解，但有复发倾向。有抑郁症状既往史的参与者即使在基线时无症状，后期患抑郁症的风险也更高。与后续症状显著相关的因素包括基线时社会支持较少、收入低于5万美元门槛、生活压力源、健康状况差以及分居。较低水平的社会支持和终生压力源仅与有多次抑郁发作的参与者的症状显著相关。近期压力事件对有多次抑郁发作的参与者的影响也更大。
在普通人群中，抑郁症近期预后良好，但具有复发性。身体健康状况差和社会支持水平低似乎会增加后期患抑郁症的风险。社会风险因素对抑郁症易感性较高的人影响可能更大。
