Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
Psychiatry Res. 2011 Dec 30;190(2-3):226-31. doi: 10.1016/j.psychres.2011.07.005. Epub 2011 Jul 28.
The aim of this study was to simultaneously examine a wide range of risk factors and clinical characteristics in their predictive value for the 1-year severity of depressive symptoms. Data from 789 participants in the Netherlands Study of Depression and Anxiety (NESDA), a large psychiatric cohort study, with a major depressive disorder (MDD) at baseline were used. Depression severity at 1-year follow-up was studied using linear and multinomial logistic regression models. Results of the analyses showed that high neuroticism, no partner and older age were found predictive of a poorer outcome independent of baseline clinical characteristics. Further, comorbid anxiety disorder, first episode, having a moderate subtype (vs. melancholic), and higher baseline depression severity predicted poorer outcome. To conclude, both risk factors and clinical characteristics independently predicted 1-year severity of depressive symptoms. The findings indicate that the prediction of prognosis and identification of persons at risk of a poor outcome should not only be based on clinical characteristics, but on risk factors as well.
本研究旨在同时考察广泛的风险因素和临床特征对抑郁症状严重程度的预测价值。研究数据来自荷兰抑郁和焦虑研究(NESDA)中的 789 名参与者,这是一项大型精神科队列研究,基线时有重性抑郁障碍(MDD)。使用线性和多项逻辑回归模型研究了 1 年随访时的抑郁严重程度。分析结果表明,神经质水平高、没有伴侣和年龄较大是独立于基线临床特征的预后不良的预测因素。此外,合并焦虑障碍、首发、中度亚型(而非忧郁型)和较高的基线抑郁严重程度预测预后不良。总之,风险因素和临床特征均可独立预测抑郁症状的 1 年严重程度。研究结果表明,预后的预测和预后不良的高危人群的识别不仅应基于临床特征,还应基于风险因素。