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抑郁症状学清单的维度作为抑郁和焦虑障碍病程的预测因子。

Dimensions of the inventory of depressive symptomatology as predictors of the course of depressive and anxiety disorders.

机构信息

Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

J Psychiatr Res. 2012 Dec;46(12):1655-61. doi: 10.1016/j.jpsychires.2012.08.024. Epub 2012 Sep 17.

Abstract

For depressive and anxiety disorders general course characteristics are known. However, prognosis varies among patients with the same diagnosis. The current study investigated whether the more homogeneous symptom dimensions of mood/cognition and anxiety/arousal, could be used to predict more differentiated prognoses than with overall course-categories. One-thousand-and-fifty-three subjects with a depressive and/or anxiety disorder from the Netherlands Study of Depression and Anxiety (NESDA) were assessed at baseline and at 2-year follow-up. Dimensions of mood/cognition and anxiety/arousal were extracted from the Self Report Inventory of Depressive Symptomatology (IDS-SR). Diagnoses at baseline and follow-up were assessed with a standardized psychiatric interview. Course trajectories were assessed with a life chart interview. Increased mood/cognition scores predicted single depression (OR = 1.80) and comorbid depression-anxiety (OR = 2.00 [CI: 1.28-2.54]) at follow-up and unfavourable course trajectories of depressive symptomatology (OR = 1.94-2.08). Increased anxiety/arousal predicted single panic disorder at follow-up (OR = 2.21 [CI: 1.62-3.03]) and unfavourable course trajectories of anxiety symptomatology (OR = 1.38-1.42). All associations remained significant when adjusted for other prognostic factors, including baseline diagnosis. In conclusion, the widely used IDS-SR can be used to measure two dimensions that contribute prognostic value on top of other, previously known prognostic factors.

摘要

对于抑郁和焦虑障碍,一般的病程特征是已知的。然而,具有相同诊断的患者的预后情况有所不同。本研究调查了情绪/认知和焦虑/唤醒等更同质的症状维度是否可以比整体病程类别更准确地预测预后。来自荷兰抑郁和焦虑研究(NESDA)的 1053 名抑郁和/或焦虑障碍患者在基线和 2 年随访时接受评估。情绪/认知和焦虑/唤醒维度从自我报告抑郁症状清单(IDS-SR)中提取。基线和随访时的诊断通过标准化精神病访谈进行评估。病程轨迹通过生活图表访谈进行评估。情绪/认知评分升高预示着随访时的单相抑郁(OR = 1.80)和共病抑郁-焦虑(OR = 2.00 [CI:1.28-2.54]),以及抑郁症状的不良病程轨迹(OR = 1.94-2.08)。焦虑/唤醒评分升高预示着随访时的单相惊恐障碍(OR = 2.21 [CI:1.62-3.03])和焦虑症状的不良病程轨迹(OR = 1.38-1.42)。在调整其他预后因素(包括基线诊断)后,所有关联仍然显著。总之,广泛使用的 IDS-SR 可以用来测量两个维度,这些维度在其他已知的预后因素之外提供预后价值。

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