Department of Psychology, University of Notre Dame, Notre Dame, IN, USA.
Psychol Med. 2012 May;42(5):899-902. doi: 10.1017/S0033291711002066.
Over the past few decades, theory and research on depression have increasingly focused on the recurrent and chronic nature of the disorder. These recurrent and chronic forms of depression are extremely important to study, as they may account for the bulk of the burden associated with the disorder. Paradoxically, however, research focusing on depression as a recurrent condition has generally failed to reveal any useful early indicators of risk for recurrence. We suggest that this present impasse is due to the lack of recognition that depression can also be an acute, time-limited condition. We argue that individuals with acute, single lifetime episodes of depression have been systematically eclipsed from the research agenda, thereby effectively preventing the discovery of factors that may predict who, after experiencing a first lifetime episode of depression, goes on to have a recurrent or chronic clinical course. Greater awareness of the high prevalence of people with a single lifetime episode of depression, and the development of research designs that identify these individuals and allow comparisons with those who have recurrent forms of the disorder, could yield substantial gains in understanding the lifetime pathology of this devastating mental illness.
在过去的几十年里，关于抑郁症的理论和研究越来越关注这种疾病的复发性和慢性特征。这些复发性和慢性形式的抑郁症非常值得研究，因为它们可能是与该疾病相关的大部分负担的原因。然而，具有讽刺意味的是，专注于抑郁症作为复发性疾病的研究通常未能揭示任何有用的复发风险早期指标。我们认为，目前的僵局是由于缺乏认识，即抑郁症也可能是一种急性、限时的疾病。我们认为，患有急性、单次发作的抑郁症的个体已被系统地从研究议程中排除，从而有效地阻止了发现可能预测哪些人在经历首次发作后会出现复发或慢性临床病程的因素。更多地了解患有单次发作抑郁症的人的高患病率，并开发出能够识别这些个体的研究设计，并与患有复发性疾病的个体进行比较，可能会在理解这种毁灭性精神疾病的终身病理方面取得重大进展。
