Department of Primary Care and Population Sciences, University College London, UK.
Br J Psychiatry. 2010 Jan;196(1):13-7. doi: 10.1192/bjp.bp.109.067116.
Factors associated with depression are usually identified from cross-sectional studies.
We explore the relative roles of onset and recovery in determining these associations.
Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months.
Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor's effect on onset is highly predictive of its impact on recovery.
Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.
与抑郁相关的因素通常是通过横断面研究来确定的。
我们探讨发病和康复在确定这些关联中的相对作用。
我们从一项队列研究中评估了 10045 名普通科就诊者的 39 种风险因素的发病和康复的风险比，这些就诊者的抑郁状况在基线、6 个月和 12 个月时进行了评估。
风险因素对发病的相对影响大于对康复的影响。对发病和维持抑郁的最强风险因素往往是时间依赖性的。除了女性性别之外，风险因素对发病的影响强度高度预测了其对康复的影响。
预防措施将比发病后消除风险因素的措施更能降低抑郁的患病率。时间依赖性风险因素的强度表明，关注近端而不是远端因素更有成效。
