Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany.
J Affect Disord. 2011 Mar;129(1-3):1-13. doi: 10.1016/j.jad.2010.03.025. Epub 2010 May 21.
One of five patients with an acute depressive episode develops chronic depression. Risk factors for a current depressive episode to become chronic are insufficiently known. This review was conducted to examine which factors represent a risk factor for the development of chronic depression for patients diagnosed with a depressive episode.
Medline, Psycinfo, ISI Web of Science, CINHAL and BIOSIS Previews were searched up until September 2007, complemented by handsearching in the December 1987 to December 2007 issues of Journal of Affective Disorders and investigating reference lists of included articles and existing reviews. On the basis of a formal checklist, two investigators independently decided which studies to include or exclude.
25 relevant primary studies with a total of 5192 participants were included in the systematic review. Overall the methodological quality of the included studies was found to be sufficient. Data synthesis was performed via vote counting. The following risk factors were identified: younger age at onset, longer duration of depressive episode, and family history of mood disorders. Psychological comorbidity i.e. anxiety disorders, personality disorders and substance abuse, low level of social integration, negative social interaction and lower severity of depressive symptoms repeatedly appeared concurrently with chronic depression.
Most included studies were cross-sectional thus drawing causal conclusions with regard to risk factors proved to be difficult.
Risk factors for a current depressive episode to become chronic were identified. To date only few significant longitudinal studies on this topic are available.
五个患有急性抑郁发作的患者中就有一个会发展为慢性抑郁症。目前对于导致抑郁发作发展为慢性的危险因素知之甚少。本综述旨在研究哪些因素会导致被诊断为抑郁发作的患者发展为慢性抑郁症。
检索了 Medline、Psycinfo、ISI Web of Science、CINHAL 和 BIOSIS Previews，截至 2007 年 9 月，并补充检索了《情感障碍杂志》1987 年 12 月至 2007 年 12 月期间的所有内容，并调查了纳入文章和现有综述的参考文献列表。根据正式的检查表，两名研究人员独立决定纳入或排除哪些研究。
共有 25 项相关的原始研究纳入了本次系统综述，共涉及 5192 名参与者。总体而言，纳入研究的方法学质量被认为是足够的。通过投票计数进行了数据综合。确定的风险因素包括：发病年龄较小、抑郁发作持续时间较长、心境障碍家族史。心理共病（如焦虑障碍、人格障碍和物质滥用）、社会融合程度低、负性社会互动以及抑郁症状严重程度较低，这些因素与慢性抑郁症同时出现。
大多数纳入的研究都是横断面研究，因此很难得出关于风险因素的因果结论。
已经确定了导致当前抑郁发作发展为慢性的风险因素。迄今为止，关于这个主题的仅有少数重要的纵向研究。
