Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark.
Psychother Psychosom. 2013;82(1):45-52. doi: 10.1159/000337746. Epub 2012 Nov 6.
Physical illness and depression are related, but the association between specific physical diseases and diagnostic subtypes of depression remains poorly understood. This study aimed to clarify the relationship between a number of physical diseases and the nonpsychotic and psychotic subtype of severe depression.
This is a historical prospective cohort study. The study population consisted of all patients diagnosed with ICD-10 severe depression, either nonpsychotic or psychotic subtype, in Danish psychiatric hospitals between 1994 and 2008. The patients' history of physical disease was assessed using the Danish National Patient Register. Using logistic regression it was investigated whether specific physical diseases were associated with relative increased risk for subsequent development of either the nonpsychotic or psychotic depressive subtype.
A total of 24,173 patients with severe depression were included in the study. Of those, 8,260 (34%) were of the psychotic subtype. A history of the following physical diseases, as opposed to their absence, increased the relative risk for subsequent development of the nonpsychotic compared to the psychotic depressive subtype [adjusted incidence odds ratio (AIOR) nonpsychotic vs. psychotic]: ischemic heart disease (AIOR = 1.3, p < 0.001), hypertension (AIOR = 1.2, p = 0.008), stroke (AIOR = 1.2, p = 0.042) and chronic lower pulmonary disease (AIOR = 1.2, p = 0.005). The total load of physical disease also increased the relative risk of nonpsychotic depression [AIOR = 1.05 (per disease), p = 0.001].
This study revealed that, in severe depression, a history of physical disease increased the relative risk of the nonpsychotic rather than the psychotic subtype.
身体疾病和抑郁症相关，但特定身体疾病与严重抑郁症的诊断亚型之间的关联仍知之甚少。本研究旨在阐明多种身体疾病与非精神病性和精神病性重度抑郁症亚型之间的关系。
这是一项历史前瞻性队列研究。研究人群包括 1994 年至 2008 年间在丹麦精神病院被诊断为 ICD-10 重度抑郁症（非精神病性或精神病性亚型）的所有患者。使用丹麦国家患者登记处评估患者的身体疾病史。使用逻辑回归研究特定的身体疾病是否与随后发生非精神病性或精神病性抑郁亚型的相对风险增加有关。
共纳入 24173 例重度抑郁症患者。其中，8260 例（34%）为精神病性亚型。与不存在这些疾病相比，以下身体疾病的病史增加了随后发展为非精神病性抑郁亚型而不是精神病性抑郁亚型的相对风险[非精神病性与精神病性调整后的发病率比值比（AIOR）]：缺血性心脏病（AIOR=1.3，p<0.001）、高血压（AIOR=1.2，p=0.008）、中风（AIOR=1.2，p=0.042）和慢性下呼吸道疾病（AIOR=1.2，p=0.005）。身体疾病的总负担也增加了非精神病性抑郁症的相对风险[AIOR=1.05（每增加一种疾病），p=0.001]。
本研究表明，在重度抑郁症中，身体疾病史增加了非精神病性而非精神病性亚型的相对风险。
