Torpey Dana C, Klein Daniel N
Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA.
Curr Psychiatry Rep. 2008 Dec;10(6):458-64. doi: 10.1007/s11920-008-0074-6.
A significant proportion of patients with depressive disorders suffer from chronic conditions. The DSM-IV recognizes several forms of chronic depression. Chronic depressions differ from nonchronic major depressive disorder (MDD) on many clinical, psychosocial, and familial variables. However, less support exists for current distinctions between the various forms of chronic depression. Antidepressant medications and at least some forms of psychotherapy are efficacious in treating chronic depression, and the combination of pharmacotherapy and psychotherapy appears to be superior to either monotherapy alone. Still, chronic depression is often inadequately treated, and many patients fail to respond or continue to experience residual symptoms after treatment. An important direction for future research is to elucidate the multiple pathways to chronic depression and to tailor treatments to specific etiopathogenetic subgroups.
相当一部分抑郁症患者患有慢性疾病。《精神疾病诊断与统计手册第四版》（DSM-IV）认可几种慢性抑郁症形式。慢性抑郁症在许多临床、心理社会和家庭变量方面与非慢性重度抑郁症（MDD）有所不同。然而，目前对各种形式慢性抑郁症之间差异的支持较少。抗抑郁药物以及至少某些形式的心理治疗在治疗慢性抑郁症方面是有效的，药物治疗和心理治疗相结合似乎优于单独的任何一种单一疗法。尽管如此，慢性抑郁症常常未得到充分治疗，许多患者治疗后没有反应或继续存在残留症状。未来研究的一个重要方向是阐明导致慢性抑郁症的多种途径，并针对特定病因亚组量身定制治疗方法。
