GGZ inGeest/Department of Psychiatry and EMGO Institute-VU University Medical Center, Amsterdam, the Netherlands.
Acta Psychiatr Scand. 2011 Apr;123(4):297-306. doi: 10.1111/j.1600-0447.2011.01677.x. Epub 2011 Feb 7.
Insight into the long-term course of depression and anxiety.
Data were derived from Netherlands Mental Health Survey and Incidence Study/Netherlands Study of Depression and Anxiety, epidemiologic surveys in the adult population in the Netherlands. Three hundred and three respondents with depressive and/or anxiety Composite International Diagnostic Interview (CIDI) disorder were interviewed, examining the 7-year course of depression (n = 141), anxiety (n = 102) and the comorbid state (n = 60) and possible prognostic factors. Outcomes were CIDI diagnostic status after 7 years and percentage of time during 7 years with depressive and/or anxiety symptoms, retrospectively assessed by the Life Chart Interview (LCI).
After 7 years, 60.7% of the subjects were free from a 12-month CIDI depression or anxiety diagnosis. The odds were higher for subjects with anxiety and comorbidity compared to subjects with depression. Low physical functioning and high neuroticism predicted the presence of a diagnosis after 7 years. During 7-year follow-up, 37.3% of the subjects were free from depressive and anxiety symptoms according to the LCI, 51.8% had symptoms <50% of the time, and 10.9%≥50% of the time. (Comorbid) anxiety resulted in a poorer course. High neuroticism and childhood adversity predicted more follow-up time with symptoms.
Course trajectories were more favorable than expected, although comorbidity resulted in poorer course. Neuroticism, physical functioning, and childhood adversity predicted an unfavorable course.
深入了解抑郁和焦虑的长期病程。
数据来自荷兰精神健康调查和发病率研究/荷兰抑郁和焦虑研究,这是荷兰成人人群的流行病学调查。对 303 名患有抑郁和/或焦虑复合国际诊断访谈(CIDI)障碍的受访者进行了访谈,研究了抑郁(n=141)、焦虑(n=102)和共病状态(n=60)的 7 年病程以及可能的预后因素。结局为 7 年后 CIDI 诊断状况以及通过生活图表访谈(LCI)回顾性评估的 7 年内抑郁和/或焦虑症状的时间百分比。
7 年后,60.7%的受试者无 12 个月 CIDI 抑郁或焦虑诊断。与抑郁患者相比,焦虑和共病患者的几率更高。低身体机能和高神经质预测 7 年后存在诊断。在 7 年的随访中,根据 LCI,37.3%的受试者无抑郁和焦虑症状,51.8%的受试者症状时间<50%,10.9%的受试者症状时间≥50%。(共病)焦虑导致病程更差。高神经质和儿童期逆境预测更多的症状随访时间。
尽管共病导致病程较差,但病程轨迹比预期的更为有利。神经质、身体机能和儿童期逆境预测预后不良。