Department of Family Medicine, University of Tartu, Puusepa 1a-2120, Tartu, Estonia.
Fam Pract. 2011 Feb;28(1):22-8. doi: 10.1093/fampra/cmq076. Epub 2010 Sep 23.
Depression has a high rate of recurrence. Finding the variables that predict which patients are at higher risk of experiencing a recurrent episode of depression would benefit an individual patient.
To determine the factors associated with recurrent depression >12 months.
Consecutive patients (N = 1094), aged 18-75 years, were recruited from 23 family practices across Estonia. The patients were followed up at 6- and 12-month intervals as suggested in the PredictD study. Depression was assessed using the Composite International Diagnostic Interview. Each participant filled in a questionnaire to assess their risk factors for depression.
Major depression was diagnosed in 13% of the patients. Twenty-eight per cent of the depressed patients had a recurrent episode of depression 12 months later. The odds of having recurrent depression were significantly higher for patients who had a history of drug abuse, odds ratio (OR) 7.48 [95% confidence interval (CI) = 1.42-39.43), for patients who had experienced discrimination, OR 2.92 (95% CI = 1.05-8.11) and for patients with a history of childhood abuse, OR 1.58 (95% CI = 1.05-2.38).
One-third of the patients developed recurrent depression. Drug abuse, discrimination and childhood abuse predicted recurrent depression. These factors should be taken into consideration by family doctors when managing patients with depression.
抑郁症复发率较高。找到能够预测哪些患者更易复发的变量将使个体患者受益。
确定与复发性抑郁症 >12 个月相关的因素。
连续招募了来自爱沙尼亚 23 个家庭诊所的 1094 名年龄在 18-75 岁的患者。根据 PredictD 研究建议，对患者进行 6 个月和 12 个月的随访。使用复合国际诊断访谈对抑郁症进行评估。每位参与者填写一份问卷以评估其抑郁症的危险因素。
13%的患者被诊断为重度抑郁症。28%的抑郁患者在 12 个月后再次出现抑郁症发作。有药物滥用史、滥用药物的几率比（OR）为 7.48（95%置信区间（CI）=1.42-39.43）、有歧视经历、OR 为 2.92（95%CI=1.05-8.11）和有儿童期虐待史的患者，OR 为 1.58（95%CI=1.05-2.38），这些患者再次出现抑郁症的几率显著更高。
三分之一的患者出现了复发性抑郁症。药物滥用、歧视和儿童期虐待预测了抑郁症的复发。家庭医生在治疗抑郁症患者时应考虑这些因素。
