Department of Behavioral Sciences and Health Education, Emory University, United States.
J Affect Disord. 2013 Sep 25;150(3):895-902. doi: 10.1016/j.jad.2013.05.008. Epub 2013 May 28.
The goal of this study was to investigate the concurrent and prospective relationships between a history of single and recurrent major depression disorder (MDD) and the medical conditions of cardiovascular disease (CVD) and diabetes using a community sample of middle- and older-aged women.
Data from women (n=557 at baseline; mean age=55.7 years) participating in a two-wave longitudinal study (5-year interval) were used to examine associations between single and recurrent MDD, assessed with a structured clinical interview, and three self-report indicators of CVD (heart attack or myocardial infarction, stroke, angina), major CVD risk markers (hypertension, high cholesterol), and diabetes. Analyses were conducted to evaluate hypotheses which proposed that recurrent depression would be significantly associated with the three medical outcomes, but not single episode MDD.
After controlling for a range of important covariates (e.g., BMI, smoking, alcohol use), cross-sectional analyses indicated that recurrent MDD, but not single episode MDD, significantly predicted CVD risk and diabetes. Prospective analyses indicated that recurrent MDD, but not single episode MDD, increased the risk for CVD and diabetes.
The sample was a predominantly white, middle-class sample so generalizability of findings may be limited for minorities and men. Reliance on self-report data may have biased the findings.
These findings suggest the benefits of measuring single versus recurrent MDD when investigating the risk of depression on chronic diseases. Findings also suggest the importance of identifying individuals suffering from recurrent MDD early in their lifespan with the goal of preventing future depressive episodes.
本研究旨在使用中年和老年女性的社区样本,调查单次和复发性重度抑郁症(MDD)病史与心血管疾病(CVD)和糖尿病的医疗状况的并发和前瞻性关系。
使用参加了两次纵向研究(5 年间隔)的女性(n=557,基线平均年龄为 55.7 岁)的数据,来检验单次和复发性 MDD(采用结构化临床访谈评估)与三种 CVD 的自我报告指标(心脏病发作或心肌梗死、中风、心绞痛)、主要 CVD 风险标志物(高血压、高胆固醇)和糖尿病之间的关联。分析采用评估假设的方法,该假设提出复发性抑郁与三种医疗结果显著相关,而单次发作的 MDD 则不然。
在控制了一系列重要的协变量(例如 BMI、吸烟、饮酒)后,横断面分析表明,复发性 MDD 而不是单次发作的 MDD 显著预测了 CVD 风险和糖尿病。前瞻性分析表明,复发性 MDD 而不是单次发作的 MDD 增加了 CVD 和糖尿病的风险。
该样本主要是白人中产阶级,因此研究结果可能对少数族裔和男性的普遍性有限。对自我报告数据的依赖可能会使研究结果产生偏差。
这些发现表明,在调查抑郁症对慢性病的风险时,测量单次与复发性 MDD 的益处。研究结果还表明,识别生命早期遭受复发性 MDD 的个体并预防未来的抑郁发作非常重要。