Department of Community Health Sciences, University of Calgary, Calgary, Alberta.
Can J Psychiatry. 2010 Oct;55(10):669-76. doi: 10.1177/070674371005501006.
Most psychiatric epidemiologic studies have used cross-sectional methods, resulting in a lack of information about the longitudinal course of depressive disorders. The objective of our study was to describe the longitudinal epidemiology of major depressive episodes (MDEs) in a Canadian sample using data from the National Population Health Survey (NPHS).
The NPHS started data collection in 1994 and has evaluated past-year MDE using repeat interviews of the same cohort every 2 years since then. In our study, we examined the number of weeks depressed during years when MDEs occurred, the proportion of respondents having MDEs at consecutive cycles, and MDE counts during follow-up.
A sizable proportion of MDEs were brief: about one-half of respondents with past-year MDE reported 8 or fewer weeks of depression during that year. Less than 10% reported that they were depressed for the entire year. However, a larger proportion (19.1%) fulfilled criteria for MDE on consecutive interview cycles, suggesting either persistence or rapid recurrence. The mean number of detected MDEs among those with at least 1 detected MDE up to 2006 was 2. Positive family history, evidence of comorbidity, negative cognitive style, stress, pain, and smoking were associated with a more negative course.
The longitudinal course of MDE in the general population is heterogeneous, including a mixture of brief and more protracted MDEs. Many risk factors for MDE are also associated with a negative course, exceptions being (younger) age and sex. These epidemiologic observations may assist with identification of patients requiring more intensive management in clinical practice.
大多数精神科流行病学研究都采用了横断面方法，因此缺乏关于抑郁障碍纵向病程的信息。我们的研究目的是使用来自加拿大全国健康调查（NPHS）的数据描述加拿大样本中主要抑郁发作（MDE）的纵向流行病学。
NPHS 于 1994 年开始收集数据，并从那时起每隔 2 年对同一队列进行重复访谈以评估过去一年的 MDE。在我们的研究中，我们检查了在发生 MDE 的年份中抑郁的周数、连续周期中出现 MDE 的受访者比例以及随访期间的 MDE 计数。
相当一部分 MDE 是短暂的：大约一半有过去一年 MDE 的受访者报告在那一年中抑郁 8 周或更短时间。不到 10%的受访者报告说他们全年都在抑郁。然而，更大的比例（19.1%）在连续访谈周期中符合 MDE 的标准，这表明要么持续存在，要么快速复发。在至少有 1 次 MDE 检测到 2006 年的患者中，检测到的 MDE 的平均数量为 2。阳性家族史、共病证据、消极认知风格、压力、疼痛和吸烟与更负面的病程相关。
一般人群中 MDE 的纵向病程是异质的，包括短暂和更持久的 MDE 混合。许多 MDE 的风险因素也与负面病程相关，例外情况是（更年轻）年龄和性别。这些流行病学观察结果可能有助于在临床实践中识别需要更强化管理的患者。
