Department of Psychology, University of Colorado, Boulder, CO, USA.
Personal Disord. 2011 Apr;2(2):83-97. doi: 10.1037/a0020456.
Major depressive disorder (MDD) is characterized by a high risk of recurrence, especially among individuals whose initial episode occurs during adolescence. Identifying predictors of recurrence of MDD among young samples is therefore of paramount clinical importance. Survival analytic models were used to evaluate the effects of dysfunctional cognitions and Axis II personality pathology on MDD recurrence in a sample of 130 previously, but not currently, depressed young adults. Participants were initially assessed for depression, dysfunctional attitudes, and personality pathology during their first semester in college and then reevaluated via the Longitudinal Interval Follow-up Evaluation interview every 6 months for 18 months. Baseline level of depressive symptoms significantly (HR-1.07, p = .002) predicted recurrence of MDD. In the survival analyses with baseline level of depression serving as a current mood state covariate, overall personality pathology (HR-1.04, p < .05), but not cognitive distortions, uniquely predicted MDD recurrence. In similar analyses, none of the specific DSM-IV personality disorder cluster scores uniquely predicted recurrence. We discussed the theoretical, empirical, and clinical implications of these findings, and we noted the limitations of the study.
重性抑郁障碍（MDD）的特征是复发风险高，尤其是在首次发作发生在青春期的个体中。因此，确定年轻人群中 MDD 复发的预测因素具有至关重要的临床意义。生存分析模型用于评估在 130 名以前但目前未患有抑郁症的年轻成年人样本中，功能失调认知和轴 II 人格病理学对 MDD 复发的影响。参与者在大学的第一学期期间接受了抑郁、功能失调态度和人格病理学的评估，然后在 18 个月内每 6 个月通过纵向间隔随访评估访谈进行重新评估。基线抑郁症状水平显著（HR-1.07，p =.002）预测 MDD 的复发。在以基线抑郁水平作为当前情绪状态协变量的生存分析中，总体人格病理学（HR-1.04，p <.05），而不是认知扭曲，可单独预测 MDD 的复发。在类似的分析中，DSM-IV 人格障碍特定聚类评分均不能单独预测复发。我们讨论了这些发现的理论、经验和临床意义，并注意到研究的局限性。
