Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Psychopathology. 2013;46(3):163-71. doi: 10.1159/000339527. Epub 2012 Sep 21.
This study reports the comparison and associations of demographic, clinical and psychosocial correlates with three unipolar depressive disorders: dysthymia (DYS), major depression (MD) and double depression (DD), and examines to which extent these variables predict the disorders.
Previously collected data from 563 adults from a community in Puerto Rico were analyzed. One hundred and thirty individuals with DYS, 260 with MD and 173 with DD were compared by demographic variables, psychiatric and physical comorbidity, familial psychopathology, psychosocial stressors, functional impairment, self-reliance, problem recognition and formal use of mental health services. Multinomial regression was used to assess the association of the predictor variables with each of the three disorders.
Similarities outweighed the discrepancies between the disorders. The main differences observed were between MD and DD, while DYS shared common characteristics with both MD and DD. After other variables were controlled, anxiety, functional impairment and problem recognition most strongly predicted a DD diagnosis, while age predicted a DYS diagnosis.
MD, DYS and DD are not completely different disorders, but they do differ in key aspects that might be relevant for nosology, research and practice. A dimensional system that incorporates specific categories of disorders would better reflect the different manifestations of unipolar depressive disorders.
本研究报告了人口统计学、临床和心理社会因素与三种单相抑郁障碍(心境恶劣障碍、重性抑郁障碍和双重抑郁障碍)的比较和关联,并探讨了这些变量在多大程度上可以预测这些障碍。
分析了来自波多黎各一个社区的 563 名成年人的先前收集的数据。通过人口统计学变量、精神和身体共病、家族精神病理学、心理社会压力源、功能障碍、自力更生、问题识别和精神卫生服务的正式使用,对 130 名心境恶劣障碍患者、260 名重性抑郁障碍患者和 173 名双重抑郁障碍患者进行了比较。使用多项回归来评估预测变量与三种障碍中每一种的关联。
相似之处超过了障碍之间的差异。观察到的主要差异存在于 MD 和 DD 之间,而 DYS 与 MD 和 DD 具有共同特征。在控制其他变量后,焦虑、功能障碍和问题识别最强烈地预测 DD 诊断,而年龄预测 DYS 诊断。
MD、DYS 和 DD 并不是完全不同的障碍,但它们在关键方面确实存在差异,这可能与分类学、研究和实践有关。一个包含特定障碍类别的维度系统将更好地反映单相抑郁障碍的不同表现。